a State Medical School at São José do Rio Preto (FAMERP) , Internal Medicine Department, Hypertension Clinic of FAMERP and Hospital de Base , São José do Rio Preto , São Paulo , Brazil.
c Cardiology and Cardiovascular Surgery Department , Medical School at São José do Rio Preto (FAMERP) , São Paulo , Brazil.
Clin Exp Hypertens. 2017;39(6):553-561. doi: 10.1080/10641963.2017.1291661. Epub 2017 Jun 1.
Hypertensive crisis is a common clinical situation that presents a high rate of morbidity and mortality and it is characterized by symptomatic rise of blood pressure (BP), systolic (SBP) ≥ 180 mmHg and/or diastolic (DBP) ≥ 120 mmHg. It is classified as emergency (HE) or hypertensive urgency (HU). There is no description of laboratory findings in patients who present acute BP elevation. Thus, this study had the objective to assess the biochemical-metabolic parameters of patients with HC. We studied 74 normotensive individuals (NT), 74 controlled hypertensive patients (ContrHT), 50 subjects with HU, and 78 with HE for evaluating biochemical-metabolic parameters. HE occurs in older individuals and more frequently in those with known hypertension. More patients with HE had dyslipidemia than those with HU (58% vs. 38%). The diastolic BP and heart rate were higher in the HE group (120 mmHg and 87 bpm) compared to ContrHT (71 mmHg and 71 bpm; p < 0.0001) and NT groups (75 mmHg and 68 bpm; p < 0.0001). Glycemia was higher in HE vs. NT and ContrHT (p < 0.05). HDL cholesterol was lower in HE than NT (p = 0.0088). Potassium was lower in HE vs. NT, ContrHT and HU groups (p < 0.05). Creatinine was higher in the HC group vs. NT and ContrHT (p < 0.05). The GFR was significantly lower in HE group vs. HU, ContrHT and NT (p < 0.001). In conclusion, individuals with HC show biochemical alterations when compared to ContrHT and NT. Acute BP elevations are associated with hyperglycemia, dyslipidemia, and higher potassium and creatinine levels and lower renal function. Abbreviations BMI = body mass index BP = blood pressure CH = hypertensive crisis ContrHT = controlled hypertensive DBP = diastolic blood pressure GFR = glomerular filtration rate HbA1c = glycated hemoglobin HDLc = high-density lipoprotein cholesterol HE = hypertensive emergency HPLC = high-performance liquid chromatography HR = heart rate HU = hypertensive urgency JNC 7 = VII Joint National Committee on the Detection, Evaluation, and Treatment of High Blood Pressure LDLc = low-density lipoprotein cholesterol MDRD = Modification of Diet in Renal Disease NT = normotensive RASB = renin-angiotensin system blockers SBP = systolic blood pressure TC = total cholesterol TG = triglycerides.
高血压危象是一种常见的临床情况，发病率和死亡率都很高，其特征是血压（BP）出现症状性升高，收缩压（SBP）≥180mmHg 和/或舒张压（DBP）≥120mmHg。它分为急症（HE）或高血压紧急情况（HU）。对于出现急性血压升高的患者，没有描述实验室检查结果。因此，本研究的目的是评估 HC 患者的生化代谢参数。我们研究了 74 名正常血压个体（NT）、74 名控制良好的高血压患者（ContrHT）、50 名 HU 患者和 78 名 HE 患者，以评估生化代谢参数。HE 发生在年龄较大的人群中，在已知患有高血压的人群中更为常见。与 HU 患者相比，HE 患者中血脂异常更为常见（58%比 38%）。HE 组的舒张压和心率高于 ContrHT 组（120mmHg 和 87bpm；p<0.0001）和 NT 组（75mmHg 和 68bpm；p<0.0001）。与 NT 和 ContrHT 相比，HE 组的血糖更高（p<0.05）。与 NT 相比，HE 组的高密度脂蛋白胆固醇水平更低（p=0.0088）。与 NT、ContrHT 和 HU 组相比，HE 组的血钾更低（p<0.05）。与 NT 和 ContrHT 相比，HE 组的肌酐更高（p<0.05）。与 NT 和 ContrHT 相比，HC 组的肾小球滤过率明显降低（p<0.001）。结论：与 ContrHT 和 NT 相比，HC 患者存在生化改变。急性血压升高与高血糖、血脂异常、血钾和肌酐水平升高以及肾功能降低有关。缩写词 BMI = 体重指数 BP = 血压 CH = 高血压危象 ContrHT = 控制良好的高血压 DBP = 舒张压 GFR = 肾小球滤过率 HbA1c = 糖化血红蛋白 HDLc = 高密度脂蛋白胆固醇 HE = 高血压急症 HPLC = 高效液相色谱 HR = 心率 HU = 高血压紧急情况 JNC 7 = VII 联合国家委员会高血压检测、评估和治疗 LDLc = 低密度脂蛋白胆固醇 MDRD = 肾脏疾病饮食改良 NT = 正常血压 RASB = 肾素-血管紧张素系统阻滞剂 SBP = 收缩压 TC = 总胆固醇 TG = 甘油三酯。
