Pharmacological blood pressure control and outcomes in patients with hypertensive crisis discharged from the emergency department.

Pharmacological blood pressure (BP) intervention for high blood pressure is controversial for a wide spectrum of hypertensive crisis in the emergency department (ED). We evaluated whether medical control of BP altered the short- and long-term outcomes among patients with hypertensive crisis who were...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Yu-Ting Lin, Yen-Hung Liu, Ya-Luan Hsiao, Hsiu-Yin Chiang, Pei-Shan Chen, Shih-Ni Chang, Hsiu-Chen Tsai, Chun-Hung Chen, Chin-Chi Kuo
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/9aab936e1ef64cf5acbff5bf1eba60fa
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:9aab936e1ef64cf5acbff5bf1eba60fa
record_format	dspace
spelling	oai:doaj.org-article:9aab936e1ef64cf5acbff5bf1eba60fa2021-12-02T20:18:01ZPharmacological blood pressure control and outcomes in patients with hypertensive crisis discharged from the emergency department.1932-620310.1371/journal.pone.0251311https://doaj.org/article/9aab936e1ef64cf5acbff5bf1eba60fa2021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0251311https://doaj.org/toc/1932-6203Pharmacological blood pressure (BP) intervention for high blood pressure is controversial for a wide spectrum of hypertensive crisis in the emergency department (ED). We evaluated whether medical control of BP altered the short- and long-term outcomes among patients with hypertensive crisis who were discharged from the ED under universal health care. This retrospective cohort comprised 22 906 adults discharged from the ED of a tertiary hospital with initial systolic BP ≥ 180 mmHg or diastolic BP ≥ 120 mmHg between 2010 and 2016. The main exposure was the use of antihypertensive medication during the ED stay. Clinical endpoints were revisits to the ED or inpatient admission (at 7, 30, and 60 days), cardiovascular mortality (at 1, 3, and 5 years), and incident stroke (at 1, 3, and 5 years). The associations between pharmacological intervention for BP and outcomes were evaluated using multivariable Cox proportional-hazards models. Of the patient data analyzed, 72.2% were not treated pharmacologically and 68.4% underwent evaluation of end-organ damage. Pharmacological intervention for BP was significantly associated with a 11% and 11% reduced risk of hospital revisits within 30 or 60 days of discharge from ED, respectively, particularly among patients with polypharmacy. No association between pharmacological intervention for BP and incident stroke and cardiovascular mortality was observed. A revision of diagnostic criteria for hypertensive crisis is essential. Although pharmacological intervention for BP may not alter the long-term risk of cardiovascular mortality, it significantly reduces short-term health care utilization.Yu-Ting LinYen-Hung LiuYa-Luan HsiaoHsiu-Yin ChiangPei-Shan ChenShih-Ni ChangHsiu-Chen TsaiChun-Hung ChenChin-Chi KuoPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 8, p e0251311 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Yu-Ting Lin Yen-Hung Liu Ya-Luan Hsiao Hsiu-Yin Chiang Pei-Shan Chen Shih-Ni Chang Hsiu-Chen Tsai Chun-Hung Chen Chin-Chi Kuo Pharmacological blood pressure control and outcomes in patients with hypertensive crisis discharged from the emergency department.
description	Pharmacological blood pressure (BP) intervention for high blood pressure is controversial for a wide spectrum of hypertensive crisis in the emergency department (ED). We evaluated whether medical control of BP altered the short- and long-term outcomes among patients with hypertensive crisis who were discharged from the ED under universal health care. This retrospective cohort comprised 22 906 adults discharged from the ED of a tertiary hospital with initial systolic BP ≥ 180 mmHg or diastolic BP ≥ 120 mmHg between 2010 and 2016. The main exposure was the use of antihypertensive medication during the ED stay. Clinical endpoints were revisits to the ED or inpatient admission (at 7, 30, and 60 days), cardiovascular mortality (at 1, 3, and 5 years), and incident stroke (at 1, 3, and 5 years). The associations between pharmacological intervention for BP and outcomes were evaluated using multivariable Cox proportional-hazards models. Of the patient data analyzed, 72.2% were not treated pharmacologically and 68.4% underwent evaluation of end-organ damage. Pharmacological intervention for BP was significantly associated with a 11% and 11% reduced risk of hospital revisits within 30 or 60 days of discharge from ED, respectively, particularly among patients with polypharmacy. No association between pharmacological intervention for BP and incident stroke and cardiovascular mortality was observed. A revision of diagnostic criteria for hypertensive crisis is essential. Although pharmacological intervention for BP may not alter the long-term risk of cardiovascular mortality, it significantly reduces short-term health care utilization.
format	article
author	Yu-Ting Lin Yen-Hung Liu Ya-Luan Hsiao Hsiu-Yin Chiang Pei-Shan Chen Shih-Ni Chang Hsiu-Chen Tsai Chun-Hung Chen Chin-Chi Kuo
author_facet	Yu-Ting Lin Yen-Hung Liu Ya-Luan Hsiao Hsiu-Yin Chiang Pei-Shan Chen Shih-Ni Chang Hsiu-Chen Tsai Chun-Hung Chen Chin-Chi Kuo
author_sort	Yu-Ting Lin
title	Pharmacological blood pressure control and outcomes in patients with hypertensive crisis discharged from the emergency department.
title_short	Pharmacological blood pressure control and outcomes in patients with hypertensive crisis discharged from the emergency department.
title_full	Pharmacological blood pressure control and outcomes in patients with hypertensive crisis discharged from the emergency department.
title_fullStr	Pharmacological blood pressure control and outcomes in patients with hypertensive crisis discharged from the emergency department.
title_full_unstemmed	Pharmacological blood pressure control and outcomes in patients with hypertensive crisis discharged from the emergency department.
title_sort	pharmacological blood pressure control and outcomes in patients with hypertensive crisis discharged from the emergency department.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/9aab936e1ef64cf5acbff5bf1eba60fa
work_keys_str_mv	AT yutinglin pharmacologicalbloodpressurecontrolandoutcomesinpatientswithhypertensivecrisisdischargedfromtheemergencydepartment AT yenhungliu pharmacologicalbloodpressurecontrolandoutcomesinpatientswithhypertensivecrisisdischargedfromtheemergencydepartment AT yaluanhsiao pharmacologicalbloodpressurecontrolandoutcomesinpatientswithhypertensivecrisisdischargedfromtheemergencydepartment AT hsiuyinchiang pharmacologicalbloodpressurecontrolandoutcomesinpatientswithhypertensivecrisisdischargedfromtheemergencydepartment AT peishanchen pharmacologicalbloodpressurecontrolandoutcomesinpatientswithhypertensivecrisisdischargedfromtheemergencydepartment AT shihnichang pharmacologicalbloodpressurecontrolandoutcomesinpatientswithhypertensivecrisisdischargedfromtheemergencydepartment AT hsiuchentsai pharmacologicalbloodpressurecontrolandoutcomesinpatientswithhypertensivecrisisdischargedfromtheemergencydepartment AT chunhungchen pharmacologicalbloodpressurecontrolandoutcomesinpatientswithhypertensivecrisisdischargedfromtheemergencydepartment AT chinchikuo pharmacologicalbloodpressurecontrolandoutcomesinpatientswithhypertensivecrisisdischargedfromtheemergencydepartment
_version_	1718374360403673088

Pharmacological blood pressure control and outcomes in patients with hypertensive crisis discharged from the emergency department.

Ejemplares similares