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Category: Volume 07 Issue 10 October 2019
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Title: A Clinical Study of acute Hypertensive urgency and Hypertensive Emergency in a Teaching Hospital

Author: Dr P Mallesham

 DOI: https://dx.doi.org/10.18535/jmscr/v7i10.01

Abstract

  

Hypertension is a growing problem of the century and over the last decade, the number of young patients with hypertension is found to be increasing. The incidence of hypertensive crisis is also found to be increasing. We in the present study tried to evaluate the clinical and epidemiological characteristics of hypertensive emergency presenting to our teaching hospital.

Methods: This prospective cross-sectional study was conducted in the Department of General Medicine, Prathima Institute of Medical Sciences, Nagunur, Karimnagar. Prior Institutional Ethical committee permission was obtained for the study.  Written consent was obtained from all the participants of the study. Inclusion criteria were adult patients >31 years of both sexes who were admitted to medical or emergency ICU with blood pressure readings of >180/120 mmHg. A detailed Clinical examination was done were fundoscopy, including ophthalmic examination; neurological deficits if any were identified. Laboratory investigations were done which includes hemoglobin,  erythrocyte sedimentation rate [ESR], complete blood count, Renal function tests (serum urea, serum creatinine, and electrolytes), Liver function tests, serum lipid profile, serum calcium, serum phosphorus serum uric acid, Electrocardiogram, 2D Echocardiogram, PA chest radiograph.

Results: The mean values of diastolic blood pressure at the time of admission in hypertensive urgency were found to be 122.55 mmHg and the mean values after treatment were 88.46 mmHg a mean change of 34mmHg. In the hypertensive emergency group, the mean values at the time of admission were 130.83 mmHg and at the time of discharge, the values were 89.06 mmHg a mean change of 41mmHg.

Conclusion: the hypertensive crisis is found more commonly in the 6th to 7th decade of age. There is the tendency of males to have a higher incidence of hypertensive crisis. Known hypertensive with some degree of target organ damage is more associated with hypertensive emergencies. Therefore strict blood pressure control and regular evaluation of the patients is necessary to prevent morbidity and mortality due to hypertensive crisis.

Keywords: Hypertensive urgency, Hypertensive Emergency, Hypertensive crisis

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Corresponding Author

Dr P Mallesham

Sri Thirumala Hospital, Opp Congress Office, Near Police Station, Peddapalli-505172, Telangana State