Research Article
Clinico-epidemiological characteristics and survival outcome of patients with hypertensive crisis at Kassala Hospital, Eastern Sudan
TajEldin M Abdallah*, Abdalazeem A Ibrahem, Ezeldein A Ali, Elbashir G Ahmed and AbdelAziem A Ali
Published: 10/31/2018 | Volume 3 - Issue 1 | Pages: 029-034
Abstract
Introduction: Hypertensive crisis (HC) is recognized consequence of inadequate blood pressure (BP) control. A hypertensive crisis is further divided into hypertensive emergency (HT-E) and hypertensive urgency (HT-U).
Method: Using a cross-sectional hospital-based study design, patients who had been diagnosed as having HC between January and October 2017 were consecutively recruited in the study. The criteria proposed by the Seventh Joint National Committee were used for the definition of HC.
Result: A total of 81 (.81%) patients newly diagnosed as having HC were enrolled in the study. Of these patients, 50 (61.7 %) patients met criteria for HT-E, while 31 (38.3%) patients had HT-U. Renal impairment (16%), stroke (30.8%), acute coronary syndrome (13.6%) and heart failure (22.2%) were predominant complications associated with HT-E. Out of 81 study subjects, 13 (16%) patients died. Although there was no significant difference in residence, history of smoking, Diabetes mellitus and history of alcohol consumption between groups, old age (P=.o22), male gender(.046), history of hypertension(.007), history of non-governmental employee(.003), poor compliance (p=.002) and high case fatality rate (p=.041) were significantly associated with hypertensive emergency (HT-E).
Conclusion: This study showed that HT-E has high case fatality rate among patients admitted with hypertensive crisis at kassala teaching Hospital. Therefore early detection of hypertension and appropriate management are the main stay for reducing morbidity and mortality among patients with hypertensive crisis.
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References
- Salkic S, Batic-Mujanovic O, Ljuca F, Brkic S. Clinical Presentation of Hypertensive Crises in Emergency Medical Services. Materia Socio-Medica. 2014; 26: 12-16. Ref.: https://goo.gl/9KGeXB
- World Health Organization. Regional Office for Eastern Mediterranean, Clinical guideline for management of hypertension. EMRO technical publication series, Cairo 2005; Ref.: https://goo.gl/Ptet95
- Federal Ministry of Health (Sudan), World Health Organization (WHO). Sudan - Khartoum STEPS Non-communicable Disease Risk Factors Survey 2005-2006; Ref.: https://goo.gl/szBnzd
- Abdelsatir S, Al-Sofi A, Elamin S, Abu-Aisha H. The potential role of nursing students in the implementation of community-based hypertension screening programs in Sudan. Arab J Nephrol Transplant. 2013; 6: 51-54. Ref.: https://goo.gl/pdC2rE
- Federal Ministry of Health and Sudan Society of hypertension (SSH). Sudan Hypertension Guideline. Non-Communicable Diseases Directorate 2012; Ref.: https://goo.gl/kWQfLR
- Pacheco HG, Victorino NM, Urquiza JP, Castillo AA, Herrera UJ, et al. Patients With Hypertensive Crises Who Are Admitted to a Coronary Care Unit. Clinical Characteristics and Outcomes. J Clin Hypertens (Greenwich). 2013; 15: 210–214. Ref.: https://goo.gl/meULki
- Chobanian AVM Bakris GL, Black HR, Cushman WC, Green LA, et al. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. JAMA. 2003; 289: 2560-2572. Ref.: https://goo.gl/q5yRQe
- Sobrinho S, Correia LC, Cruz C, Santiago M, Paim AC, et al. Occurence rate and clinical predictors of hypertensive pseudocrisis in emergency room care. Arq Bras Cardiol 2007; 88: 579–584. Ref.: https://goo.gl/XApHHX
- O’Brien E, Asmar R, Beilin L, Imai Y, Mancia G, et al. European Society of Hypertension Working Group on Blood Pressure Monitoring. Practice guidelines of the European Society of Hypertension for clinic, ambulatory and self-blood pressure measurement. J Hypertens. 2005; 23: 697–701. Ref.: https://goo.gl/y9Q92F
- World Medical Association. declaration of Helsinki .Ethical research involving Human Subjects. JAMA 2013; 310: 2191-2194. Ref.: https://goo.gl/LWrbVN
- Cerrillo MR, Hernandez PM, Pinilla CF, Claros NM, Otero ML. Hypertensive Crises: prevalence and clinical aspects. Rev Clin Esp 2002; 202: 255-258. Ref.: https://goo.gl/A4gPTK
- Zampaglione B, Pascale C, Marchisio M, Cavallo-Perin P. Hypertensive urgencies and emergencies. Prevalence and clinical presentation. Hypertension. 1996; 27: 144-147. Ref.: https://goo.gl/aSuoME
- Monteiro F, Anunciac Filhoetal F. Prevalence of true hypertensive crises and appropriateness of the medical management in patients with high blood pressure seen in a general emergency room. Arq Bras Cardiol. 2008; 90: 247–251. Ref.: https://goo.gl/9vRmQL
- Almas A, Ghouse A, Iftikhar AR, Khursheed M. Hypertensive Crisis, Burden, Management, and Outcome at a Tertiary Care Center in Karachi. International Journal of Chronic Diseases 2014; 1-7. Ref.: https://goo.gl/oZiBy7
- Nobre F, Chauchar F, Viana J, Pereira G, Lima N. Factors related to the clinical demand of a emergency service of a general and your understanding. Arq Bras Cardiol 2002; 78: 156-158.
- Al-Bannay R, Husain A. Hypertensive crisis. Clinical presentation, comorbidities and target organ involvement. Saudi Med J. 2010; 31: 916-920. Ref.: https://goo.gl/p3AGmq
- Piyanuttapull S, Angsanakul J. Prevalence of Hypertensive Emergency in Emergency Room of Rajavithi Hospital. J Hypertens Manag. 2016; 2: 1-4. Ref.: https://goo.gl/yQntCv
- Martin JF, Higashiama E, Garcia E, Luizon MR, Cipullo JP. Hypertensive crisis profile. Prevalence and clinical presentation. Arq Bras Cardiol 2004; 83: 125–130. Ref.: https://goo.gl/6ug39M
- Vilela-Martin JF, Vaz-de-Melo RO, Kuniyoshi CH, Abdo ANR, Toledo JCY. Hypertensive crisis: clinical–epidemiological profile. Hypertension Research. 2011; 34: 367–371. Ref.: https://goo.gl/BGVkDP
- Moreira GC, Cipullo JP, Martin JF, Ciorlia LA, Godoy MR, et al. Evaluation of the awareness, control and cost-effectiveness of hypertension treatment in a Brazilian city: populational study. J Hypertens. 2009; 27: 1900–1907. Ref.: https://goo.gl/nkHFRr
- Julius S. Borderline hypertension: an overview. Med Clin North Am. 1977; 61: 495-511. Ref.: https://goo.gl/qJF9GJ
- Messerli F, Garavaglia GE, Schmieder RE, Sundgaard-Riise K, Nunez BD, et al. Disparate cardiovascular findings in men and women with essential hypertension. Ann Intern Med 1987; 107: 158-161. Ref.: https://goo.gl/7QZtbm
- Vilela MJ, Érika H, Evandro G, Rizzatti LM, Paulo CJ. Hypertensive crisis profile: prevalence and clinical presentation. Arq. Bras.Cardiol. 2004; 83: 125-130. Ref.: https://goo.gl/byofSQ
- Lanthier L, Malenfant L, Lacelle MJ. Characteristics of hypertensive emergencies and urgencies at Sherbrooke between 1998 and 2006. Can J Gen Intern Med. 2008; 3: 38–40. Ref.: https://goo.gl/eLyUoA
- Serrano VC, Freites GQ, Delgado LL, García BMF. Behavior of the hypertensive crisis present in patients from NA integral diagnosis medical center. Rev Cubana Med Gen Integr. 2009; 25: 129–135. Ref.: https://goo.gl/4EriVG
- Katz JN1, Gore JM, Amin A, Anderson FA, Dasta JF, et al. Practice patterns, outcomes, and end‐organ dysfunction for patients with acute severe hypertension: the Studying the Treatment of Acute hyperTension (STAT) registry. Am Heart J. 2009; 158: 599‐606. Ref.: https://goo.gl/ND9dbL
- Badheka A, Shenoy M, Rathod A, Tuliani T, Afonso L. Long‐term mortality and role of troponin elevation in hypertensive emergencies. Am J Cardiol. 2012; 109: 600. Ref.: https://goo.gl/7gj7aw
- AlBannaya R, Husain A, Böhm M, Wagenpfeil S. Outcomes after hypertensive crisis: Comparison between diabetics and non-diabetics. IJC Metabolic & Endocrine 2015; 7: 25-30. Ref.: https://goo.gl/QyYUdC














