Abstract

Hypertensive emergencies refers to a large spectrum of clinical presentations secondary to uncontrolled blood pressure (BP) with subsequent progressive or impending end-organ dysfunction. Hypertensive emergency (HE) needs early differentiation from hypertensive urgency (HU) for early institution of successful management. Oral AHTT with diuretics, renin-angiotensin-aldosterone system inhibitors and/or calcium channel blockers are indicated to achieve BP control in patients of HU. Our study would be helpful in understanding the spectrum of clinical presentation and outcome of HE especially related to cardiovascular, central nervous and renal systems in our tertiary care centre along with assessment of its occurrence and causes. Material and Methods: Inclusion Criteria are all patients above 18 years of age having Systolic BP>180mmHg & Diastolic BP>120mmHg with clinico-biochemical evidence of end-organ damage (EOD). Exclusion Criteria are pregnancy, Known cases of Chronic renal failure, Valvular heart disease, Known cases of secondary hypertension. Results: This hospital-based, prospective, observational study was conducted in the on 81 OPD/IPD/Emergency patients of/in the Department of Internal Medicine, Teerthanker Mahaveer Medical College and Research Centre. In our study 35.8% of study subjects were above 60 years. 44.4% were female, most common presenting symptom was left/ right weakness 25.9%, 44.4% of subjects CVA was the clinical diagnosis. Out of 31 subjects in whom CT scan for head was done, 22.2% had hemorrhage while 13.5% had infarct. 16% of subjects showed cardiac hypertrophy on 2D-ECHO. The mean systolic blood pressure was high at admission and significantly decreased with each follow up at 1, 2 and 3 months. Conclusion: Acute elevation in blood pressure is a common presentation in emergency department. Patients need aggressive and controlled reduction in blood pressure using intravenous antihypertensive therapy for preventing the associated morbidity and mortality secondary to end-organ damage especially strokes and myocardial complications

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