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

Joshua Allgaier*, Megan Emmich, Vida Rastegar, Mihaela S. Stefan, Tara Lagu

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

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.

Original languageEnglish (US)
Pages (from-to)824-828
Number of pages5
JournalHeart and Lung
Volume49
Issue number6
DOIs
StatePublished - Nov 1 2020
Externally publishedYes

Keywords

  • Hypertension
  • Hypertensive crisis
  • Hypertensive urgency

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine
  • Cardiology and Cardiovascular Medicine

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