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Hypertension urgency emergency

Mario Hensel, Markus Stuhr, Daniel Geppert, Jan F Kersten, Jürgen Lorenz, Thoralf Kerner
OBJECTIVE: To test the hypothesis that more cardiovascular emergencies occur at low rather than at high temperatures under moderate climatic conditions. METHODS: This was a prospective observational study performed in a prehospital setting. Data from the Emergency Medical Service in Hamburg (Germany) and from the local weather station were evaluated over a 5-year period. Temperature data were matched with the associated rescue mission data. Lowess-Regression analysis was performed to assess the relationship between the temperature and the frequency of individual cardiovascular emergencies...
November 8, 2016: International Journal of Cardiology
Fátima Aparecida Lotufo, Mary Angela Parpinelli, Maria José Osis, Fernanda Garanhani Surita, Maria Laura Costa, José Guilherme Cecatti
BACKGROUND: Eclampsia is the main cause of maternal death in Brazil. Magnesium sulfate is the drug of choice for seizure prevention and control in the management of severe preeclampsia and eclampsia. Despite scientific evidence demonstrating its effectiveness and safety, there have been delays in managing hypertensive disorders, including timely access to magnesium sulfate. To conduct a general situational analysis on availability and use of magnesium sulfate for severe preeclampsia and eclampsia in the public health system...
2016: BMC Pregnancy and Childbirth
M Gabba, F Salinaro, R Mussinelli, M Boldrini, A Raimondi, C Belotti, A Maggi, T Perrone, M A Bressan, S Perlini
OBJECTIVE: Current ESH Guidelines are extensively devoted to diagnosis, management and follow-up of arterial hypertension in the "chronic" setting, whereas less attention is given to the acute management of hypertensive crises, a group of potentially life-threatening complications. Moreover, epidemiological data concerning hypertensive crises are limited. DESIGN AND METHOD: During 2014, 457 consecutive patients with an initial systolic blood pressure (SBP) >170 mmHg and/or diastolic blood pressure (DBP) >110 mmHg were enrolled after being admitted to an Emergency Department (ED) serving a population of more than 50000 inhabitants, RESULTS: : Hypertensive crises represented 0...
September 2016: Journal of Hypertension
Aditya V Karhade, Viren S Vasudeva, Hormuzdiyar H Dasenbrock, Yi Lu, William B Gormley, Michael W Groff, John H Chi, Timothy R Smith
OBJECTIVE The goal of this study was to use a large national registry to evaluate the 30-day cumulative incidence and predictors of adverse events, readmissions, and reoperations after surgery for primary and secondary spinal tumors. METHODS Data from adult patients who underwent surgery for spinal tumors (2011-2014) were extracted from the prospective National Surgical Quality Improvement Program (NSQIP) registry. Multivariable logistic regression was used to evaluate predictors of reoperation, readmission, and major complications (death, neurological, cardiopulmonary, venous thromboembolism [VTE], surgical site infection [SSI], and sepsis)...
August 2016: Neurosurgical Focus
Hormuzdiyar H Dasenbrock, Sandra C Yan, Vamsidhar Chavakula, William B Gormley, Timothy R Smith, Elizabeth Claus, Ian F Dunn
INTRODUCTION: Although reoperation has been utilized as a metric of quality of care, no national analysis has evaluated the rate of, reasons for, and predictors of unplanned reoperation after craniotomy for tumor. METHODS: Patients who underwent cranial tumor resection were extracted from the prospective National Surgical Quality Improvement Program (NSQIP) registry (2012-2014). Multivariable logistic regression examined predictors of an unplanned cranial reoperation...
August 2016: Neurosurgery
Ryan Ng, Claire E Kendall, Ann N Burchell, Ahmed M Bayoumi, Mona R Loutfy, Janet Raboud, Richard H Glazier, Sean Rourke, Tony Antoniou
BACKGROUND: Emergency department use may reflect poor access to primary care. Our objective was to compare rates and causes of emergency department use between adults living with and without HIV. METHODS: We conducted a population-based study involving Ontario residents living with and without HIV between Apr. 1, 2011, and Mar. 31, 2012. We frequency matched adults with HIV to 4 HIV-negative people by age, sex and census division, and used random-effects negative binomial regression to compare rates of emergency department use...
April 2016: CMAJ Open
Krishna K Patel, Laura Young, Erik H Howell, Bo Hu, Gregory Rutecki, George Thomas, Michael B Rothberg
IMPORTANCE: The prevalence and short-term outcomes of hypertensive urgency (systolic blood pressure ≥180 mm Hg and/or diastolic blood pressure ≥110 mm Hg) are unknown. Guidelines recommend achieving blood pressure control within 24 to 48 hours. However, some patients are referred to the emergency department (ED) or directly admitted to the hospital, and whether hospital management is associated with better outcomes is unknown. OBJECTIVES: To describe the prevalence of hypertensive urgency and the characteristics and short-term outcomes of these patients, and to determine whether referral to the hospital is associated with better outcomes than outpatient management...
July 1, 2016: JAMA Internal Medicine
Christine Chim, Erica Dimitropoulos, Regina Ginzburg
BACKGROUND: The use of short-acting agents, such as clonidine, for hypertensive urgency has been shown to worsen outcomes and, therefore, should be avoided in the office. OBJECTIVES: The primary objective was to achieve decreased rates of clonidine orders for immediate treatment of asymptomatic hypertension in the office. The secondary objective was to determine if reduced use leads to a decline in poor outcomes. METHODS: This was an observational cohort study evaluating a protocol and algorithm developed by clinical pharmacists on the appropriate management of hypertensive urgencies...
July 2016: Annals of Pharmacotherapy
K Adoubi, F Diby, F Sall, P Ouattara, A Gnaba, I Ouattara, H Yangni-Angate
OBJECTIFS: La présence d'une hypertension artérielle sévère au cours d'une urgence cardiovasculaire semble être un critère surajouté de mauvais pronostic. L'objectif de ce travail était d'apprécier la place et la gravité des urgences hypertensives dans le groupe des urgences cardiovasculaires. MéTHODES: Nous avons réalisé une étude décrivant et comparant les urgences hypertensives avec les autres urgences cardiovasculaires dans le Service des Urgences Médicales du CHU de Bouaké chez les patients admis entre janvier 2011 et décembre 2014...
December 2015: Annales de Cardiologie et D'angéiologie
H Guiga, G Sarlon Bartoli, F Silhol, W Radix, B Vaïsse
OBJECTIFS: Étudier la prévalence et la gravité des urgences et des poussées hypertensives dans un Service d'Urgence Hospitalière de CHU, et effectuer un suivi à 3 mois des patients hospitalisés. MéTHODES: Cette étude prospective a été réalisée dans le Service des Urgences entre le 1(er)(a)vril et le 31 juin 2015 : tous les patients avec une PA > 180 et/ou 110mmHg ont été comptabilisés et classés en urgences vraies (présence d'une souffrance viscérale) et en poussées hypertensives isolées...
December 2015: Annales de Cardiologie et D'angéiologie
Cynthia M Cooper, Andrew Z Fenves
The prevalence of hypertension in the general population has steadily climbed over the past several decades and hypertension is a primary or secondary diagnosis in nearly a fourth of hospitalized adults. Hospitalization is often a time of pertubation in a patient's usual blood pressure control, with pain, anxiety and missed medications all risk factors for severe hypertension. Hospitalists are often faced with severe hypertension in a patient not previously known to them and this presents a challenge of how best to assess the clinical importance of blood pressure elevation...
2016: Hospital Practice (Minneapolis)
Charan Yerasi, Nevin C Baker, Anil K Jonnalagadda, Rebecca Torguson, Suman Singh, Judith Vies, Ron Waksman
The screening of patients referred for the Symplicity Renal-Denervation Catheter Therapy on Resistant Hypertension (SYMPLICITY HTN-3) trial was rigorous, with many found not eligible to participate. We investigate patients who were not included in the trial and evaluate their current hypertensive (HTN) therapy, control and clinical status. A retrospective review and telephone interview was performed 8-10 months postscreening on 45 patients and their referring providers who were ultimately not included. Patients were grouped into 4 categories: (1) noninterest; (2) excluded (not meeting inclusion criteria); (3) screen failure (excluded during screening visits due to adequate blood pressure control guided by HTN specialist); or (4) referred after enrollment closure...
December 2015: Journal of the American Society of Hypertension: JASH
Sabina Salkic, Selmira Brkic, Olivera Batic-Mujanovic, Farid Ljuca, Almedina Karabasic, Sehveta Mustafic
AIM: The aim of the study was to evaluate efficiency of hypertensive urgency treatment using inhibitors of α1-adrenergic receptors and angiotensin converting enzyme inhibitors-ACE inhibitors in the Emergency Room of Outpatient Hospital and Polyclinic "dr Mustafa Šehovic" Tuzla in relation to age, duration and severity of hypertension. METHODS: The study was conducted from June 2011 to May 2012 and included 120 patients of both sexes diagnosed with arterial hypertension, aged 40 to 80 with verified hypertensive urgency...
October 2015: Medical Archives
Akiyo Tanabe
A hypertensive emergency is medical condition with severe hypertension involves acute and rapidly progressed target cardiovascular organ damage. This situation requires immediate blood pressure reduction to prevent lethal target-organ damage. A patient must be treated under intensive-care monitoring and with intravenous antihypertensive medicines. To avoid organ ischemia which is caused by rapid reduction in blood pressure, the recommended aims are reduction of mean arterial pressure by no more than 25% during the first one hour, followed by 160/100-110 mmHg within the next 2-6 hours...
November 2015: Nihon Rinsho. Japanese Journal of Clinical Medicine
Deborah A Taylor
Hypertensive crisis presents as hypertensive urgency or hypertensive emergency, the differences being the presence or absence of target organ damage (TOD) and the type of treatment the patient will receive. Patients with hypertensive urgency do not express TOD, which is seen only in hypertensive emergencies and can involve the heart, kidneys, or brain. Recognition of hypertensive crisis at initial assessment is crucial. An important first step is to obtain a full medical and medication history to be used as a guide for treatment...
December 2015: Critical Care Nursing Clinics of North America
Adnan Kaya, Mustafa Adem Tatlisu, Tugba Kaplan Kaya, Ozlem Yildirimturk, Baris Gungor, Baran Karatas, Selcuk Yazici, Muhammed Keskin, Sahin Avsar, Ahmet Murat
BACKGROUND: There are confusing data in literature regarding oral and sublingual captopril effects over blood pressure (BP) decrease. OBJECTIVES: In our study we compared oral and sublingual captopril effectiveness over BP decrease in patients admitted to our Emergency Department with hypertensive urgency. METHODS: Our study was conducted from January 2012 to January 2013 in patients with hypertensive urgency. In this cross-sectional study after two initial BP measurements, patients were identified as eligible for the study...
January 2016: Journal of Emergency Medicine
David Giang Phan, Céline Dreyfuss-Tubiana, Jacques Blacher
Hypertension is a common disease, the most common chronic disease. Hypertensive emergency is much less frequent and only affects 1 to 2 % of all hypertensive patients. The true hypertensive emergency is characterized by the serious damage of one hypertensive target organ and requires an urgent intravenous treatment. Isolated blood pressure elevation should not be regarded as a hypertensive emergency if there is no target organ damage, even if the blood pressure is very high. These situations of "false hypertensive emergency", or hypertensive urgencies, often requires an immediate treatment, but oral...
July 2015: La Presse Médicale
Angel López-Candales
Hypertension (HTN) is a very prevalent and growing clinical problem that is not always promptly diagnosed and ∼6% of U.S. adults remain undiagnosed. Though numerous risk factors have been linked to the development of HTN, ethnicity has traditionally been simply considered as a significant risk among non-Hispanic Blacks. However, emerging data seems to suggest that Hispanics, the largest and fastest-growing minority in the U.S.A., might have rates of uncontrolled HTN that significantly exceeds the rates observed for non-Hispanic whites...
August 2015: Postgraduate Medicine
Wen-Chieh Yang, Mao-Jen Lin, Chun-Yu Chen, Han-Ping Wu
Hypertensive emergencies and hypertensive urgencies in children are uncommonly encountered in the pediatric emergency department and intensive care units, but the diseases are potentially a life-threatening medical emergency. In comparison with adults, hypertension in children is mostly asymptomatic and most have no history of hypertension. Additionally, measuring accurate blood pressure values in younger children is not easy. This article reviews current concepts in pediatric patients with severe hypertension...
June 16, 2015: World Journal of Clinical Cases
Meera Yogarajah, Bhradeev Sivasambu, Eric A Jaffe
Iliopsoas haematoma is a rare clinical entity which can be life threatening in extreme cases. We are reporting a case of iliopsoas haematoma as a complication of hypertensive urgency. A 67-year old woman presented to emergency room with hypertensive urgency and hip pain. During hospitalisation, her haemoglobin was decreasing and on further evaluation, she did not have any signs of external bleeding and laboratory results were not suggestive of haemolysis. CT scan of abdomen and pelvis revealed a spontaneous iliopsoas haematoma...
February 26, 2015: BMJ Case Reports
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