"Hypertensive urgency or emergency? The use of intravenous medications in hospitalized hypertensive patients without organ dysfunction" by Joshua Allgaier, DO

Article

Hypertensive urgency or emergency? The use of intravenous medications in hospitalized hypertensive patients without organ dysfunction

All Scholarly Works

Joshua Allgaier, DO, Baystate Health
Megan Emmich, Baystate Health
Vida Rastegar, Baystate Health
Mihaela Stefan, MD, Baystate Health
Tara Lagu, Baystate Health

Link

Document Type

Article, Peer-reviewed

Publication Date

10-1-2020

Disciplines

Medicine and Health Sciences

Abstract

Background: Current guidelines poorly define hypertensive urgency and recommend Oral (PO) medications over intravenous (IV).

Objective: To describe hospital management of hypertensive urgency and compare characteristics and outcomes of PO vs. IV medications.

Methods: We used descriptive statistics and created generalized linear models to evaluate within-subject blood pressure (BP) changes over 24 hours.

Results: 179 patients had an average age of 62 and 58% female. Chronic hypertension was common (165, 88%), as was chronic renal disease (40.6%). IV medications were common (146, 81.6%) and associated with higher comorbidity burden, prior kidney disease, and longer length of stay (2.5, 1.6-3.8 vs. 1.4, 0.9-2.2, p=0.007). 66 (35.3%) developed and 43 (23.5%) new organ dysfunction, but outcomes were similar between groups. BP was similar between groups after 12 hours.

Conclusions: IV medication use was common and decreased BP more rapidly. Outcomes including BP were similar to PO administration, except for length of stay.

Keywords: Hypertension; Hypertensive crisis; Hypertensive urgency.

PMID

33011460

Citation Information

Allgaier J, Emmich M, Rastegar V, Stefan MS, Lagu T. Hypertensive urgency or emergency? The use of intravenous medications in hospitalized hypertensive patients without organ dysfunction. Heart Lung. 2020 Oct 1;49(6):824-828. doi: 10.1016/j.hrtlng.2020.09.014. Epub ahead of print.