title: Patients with hypertensive crises who are admitted to a coronary care unit: clinical characteristics and outcomes.
abstract: Patients with hypertensive crises, especially hypertensive emergencies, require immediate admittance to an intensive care unit for rapid blood pressure (BP) control. The authors analyzed the prevalence of hypertensive crisis, the clinical characteristics, and the evolution of patients with hypertensive emergencies and urgencies. Patients were divided into 3 groups according to their BP values: group I, predominant systolic hypertension (≥180/≤119 mm Hg); group II, severe systolic and diastolic hypertension (≥180/≥120 mm Hg); and group III, predominant diastolic hypertension (≤179/≥120 mm Hg). Of all of the patients admitted to a coronary care unit, 538 experienced a hypertensive crisis, which represented 5.08% of all admissions. Hypertensive emergency was predominant in 76.6% of the cases, which corresponded to acute coronary syndrome and acute decompensated heart failure in 59.5% and 25.2% of the cases, respectively. A pattern of predominant systolic hypertension (≥180/≤119 mm Hg) was most commonly observed in the hypertensive crisis group (71.4%) and the hypertensive emergency group (72.1%). The medications that were most commonly used at onset included intravenous vasodilators (nitroglycerin in 63.4% and sodium nitroprusside in 16.4% of the patients). The overall mortality rate was 3.7%. The mortality rate was 4.6% for hypertensive emergency cases and 0.8% for hypertensive urgencies cases.
authors: Coronary Care Unit, National Institute of Cardiology, Mexico City, Mexico. hectorglezp@hotmail.com
authors: Héctor
authors: H
authors: González Pacheco
authors: Neisser
authors: N
authors: Morales Victorino
authors: Juan Pablo
authors: JP
authors: Núñez Urquiza
authors: Alfredo
authors: A
authors: Altamirano Castillo
authors: Ursulo
authors: U
authors: Juárez Herrera
authors: Alexandra
authors: A
authors: Arias Mendoza
authors: Francisco
authors: F
authors: Azar Manzur
authors: Jose Luis
authors: JL
authors: Briseño de la Cruz
authors: Carlos
authors: C
authors: Martínez Sánchez
mesh_terms: D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects; D003325:Coronary Care Units / Q000706:statistics & numerical data*; D004630:Emergencies; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology; D008297:Male; D008800:Mexico; D008875:Middle Aged; D015995:Prevalence
chemical_list: D000959:Antihypertensive Agents