Guiga Haythem, Decroux Clémentine, Michelet Pierre, Loundou Anderson, Cornand Dimitri, Silhol François, Vaisse Bernard, Sarlon-Bartoli Gabrielle
Unité d'Hypertension Artérielle, Assistance Publique Hôpitaux de Marseille - Hôpital de la Timone, Marseille, France.
Service d'Accueil des Urgences de la Timone, Assistance Publique des Hôpitaux de Marseille, Marseille, France.
J Clin Hypertens (Greenwich). 2017 Nov;19(11):1137-1142. doi: 10.1111/jch.13083. Epub 2017 Sep 3.
Long-term mortality in patients with acute severe hypertension is unclear. The authors aimed to compare short-term (hospital) and long-term (12 months) mortality in these patients. A total of 670 adults presenting for acute severe hypertension between January 1, 2015, and December 31, 2015, were included. A total of 57.5% were hypertensive emergencies and 66.1% were hospitalized: 98% and 23.2% of those with hypertensive emergencies and urgencies, respectively (P = .001). Hospital mortality was 7.9% and was significantly higher for hypertensive emergencies (12.5% vs 1.8%, P = .001). At 12 months, 106 patients died (29.4%), mainly from hypertensive emergencies (38.9% vs 8.9%, P = .001). Median survival was 14 days for neurovascular emergencies and 50 days for cardiovascular emergencies. Patients with hypertensive emergencies or urgencies had bad long-term prognosis. Short-term mortality is mainly caused by neurovascular emergencies, but cardiovascular emergencies are severe, with high mortality at 12 months. These results justify better follow-up and treatment for these patients.
急性重度高血压患者的长期死亡率尚不清楚。作者旨在比较这些患者的短期（住院期间）和长期（12个月）死亡率。纳入了2015年1月1日至2015年12月31日期间因急性重度高血压就诊的670名成年人。其中57.5%为高血压急症，66.1%住院治疗：高血压急症和亚急症患者分别为98%和23.2%（P = 0.001）。住院死亡率为7.9%，高血压急症患者的死亡率显著更高（12.5%对1.8%，P = 0.001）。12个月时，106名患者死亡（29.4%），主要死于高血压急症（38.9%对8.9%，P = 0.001）。神经血管急症患者的中位生存期为14天，心血管急症患者为50天。高血压急症或亚急症患者的长期预后较差。短期死亡率主要由神经血管急症引起，但心血管急症较为严重，12个月时死亡率较高。这些结果证明对这些患者进行更好的随访和治疗是合理的。
