Vlcek Marianne, Bur Andreas, Woisetschläger Christian, Herkner Harald, Laggner Anton N, Hirschl Michael M
Department of Emergency Medicine, General Hospital, University of Vienna.
J Hypertens. 2008 Apr;26(4):657-62. doi: 10.1097/HJH.0b013e3282f4e8b6.
To determine whether patients with hypertensive urgency have a higher risk for subsequent cardiovascular events compared with hypertensive patients without this event.
Overall, 384 patients with hypertensive urgency and 295 control patients were followed up for at least 2 years. Hypertensive urgency was defined as a systolic blood pressure above 220 mmHg and/or a diastolic blood pressure above 120 mmHg without any evidence of acute end-organ damage. The control group consisted of patients admitted to the emergency department with a systolic blood pressure between 135 to 180 mmHg and a diastolic blood pressure between 85-110 mmHg. The number of cardiovascular events defined as acute coronary syndrome, acute stroke, atrial fibrillation, acute left ventricular failure and aortic aneurysm were consecutively analyzed during follow-up. The median follow-up time was 4.2 years (interquartile range 2.9-5.7 years). Twenty-six patients of the urgency group and 23 patients of the control group were lost for follow-up.
Overall, 117 (17%) patients had nonfatal clinical cardiovascular events and 13 had (2%) fatal cardiovascular events. The frequency of cardiovascular events was significantly higher in patients with hypertensive urgencies (88 vs. 42; P = 0.005). The Cox regression analysis identified age (P < 0.001) and hypertensive urgencies (P = 0.035) as independent predictors for subsequent cardiovascular events.
Hypertensive urgencies are associated with an increased risk for subsequent cardiovascular events in patients with arterial hypertension.
确定与无高血压急症的患者相比，高血压急症患者发生后续心血管事件的风险是否更高。
总体而言，对384例高血压急症患者和295例对照患者进行了至少2年的随访。高血压急症定义为收缩压高于220 mmHg和/或舒张压高于120 mmHg，且无任何急性终末器官损害的证据。对照组由收缩压在135至180 mmHg之间且舒张压在85 - 110 mmHg之间的急诊科入院患者组成。在随访期间连续分析定义为急性冠状动脉综合征、急性卒中、心房颤动、急性左心室衰竭和主动脉瘤的心血管事件数量。中位随访时间为4.2年（四分位间距2.9 - 5.7年）。急症组有26例患者和对照组有23例患者失访。
总体而言，117例（17%）患者发生了非致命性临床心血管事件，13例（2%）患者发生了致命性心血管事件。高血压急症患者的心血管事件发生率显著更高（88例对42例；P = 0.005）。Cox回归分析确定年龄（P < 0.001）和高血压急症（P = 0.035）为后续心血管事件的独立预测因素。
高血压急症与动脉高血压患者后续心血管事件风险增加相关。
