Sunday, August 21, 2016

Hypertensive Urgency

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Ref: “Characteristics and Outcomes of Patients Presenting With Hypertensive Urgency in the Office Setting”
"And you don’t need to be sent to “time out” – i.e., referred to the Emergency Department – solely because of it.
This is a retrospective, single-center report regarding the incidence of adverse events in patients found to have “hypertensive urgency” in the outpatient setting. This was defined formally as any systolic blood pressure measurement ≥180 mmHg or diastolic measurement ≥110 mmHg. Their question of interest was, specifically, whether patients referred to the ED received clinically-important diagnosis (“major adverse cardiovascular events”), with a secondary interest in whether their blood pressure was under better control at future outpatient visits..." (Spoiler answer: Nooop!)  Jama. Conclusions and relevance: "Hypertensive urgency is common, but the rate of MACE in asymptomatic patients is very low. Visits to the ED were associated with more hospitalizations, but not improved outcomes. Most patients still had uncontrolled hypertension 6 months later."