Benenson Irina, Waldron Frederick A, Jadotte Yuri T, Holly Cheryl
Rutgers University School of Nursing, Newark, USA.
The Northeast Institute for Evidence Synthesis and Translation (NEST): a Joanna Briggs Institute Centre of Excellence.
JBI Database System Rev Implement Rep. 2019 Nov;17(11):2343-2349. doi: 10.11124/JBISRIR-2017-003996.
The objective of this review is to conduct comprehensive appraisal and synthesis of evidence on risk factors for hypertensive crisis and, specifically, hypertensive emergencies among adult patients with hypertension.
Hypertensive crisis is the most extreme form of poorly controlled hypertension that may lead to acute target organ damage (hypertensive emergency). Hypertensive crisis is associated with increased mortality, high utilization of health care and escalated healthcare costs.
This review will include epidemiological studies with participants over 18 years old with diagnosis of hypertension. The review will exclude pediatric, pregnant and postpartum patients. The review will consider studies that explore risk factors for hypertensive crisis, defined as an acute elevation of blood pressure equal or above 180/110 mmHg.
The search strategy aims to find both published and unpublished studies. The databases to be searched will include MEDLINE (Ovid), Embase, Cochrane Database of Systematic Reviews and Web of Science. Following the search, all identified studies will be screened against the inclusion criteria. Selected studies will be critically appraised for methodological quality. Data on exposures and outcomes will be extracted from papers included in the review. Quantitative data, where possible, will be pooled in meta-analysis. Effect sizes expressed as odds ratio and their 95% confidence intervals will be calculated. Heterogeneity of studies will be assessed statistically. Subgroup analysis to determine the association of risk factors with hypertensive emergencies will be conducted, if possible. Where statistical pooling is not possible, the findings will be presented in a narrative form.
PROSPERO CRD42019140093.
本综述的目的是对高血压成年患者中高血压危象，特别是高血压急症的危险因素证据进行全面评估和综合分析。
高血压危象是血压控制不佳的最极端形式，可能导致急性靶器官损害（高血压急症）。高血压危象与死亡率增加、医疗保健利用率高和医疗费用上升有关。
本综述将纳入对18岁以上高血压患者的流行病学研究。本综述将排除儿科、妊娠和产后患者。本综述将考虑探索高血压危象危险因素的研究，高血压危象定义为血压急性升高至180/110 mmHg及以上。
检索策略旨在查找已发表和未发表的研究。将检索的数据库包括MEDLINE（Ovid）、Embase、Cochrane系统评价数据库和科学网。检索后，将根据纳入标准对所有识别出的研究进行筛选。将对选定的研究进行方法学质量的严格评估。将从综述中纳入的论文中提取暴露和结局数据。如有可能，将对定量数据进行荟萃分析。将计算以比值比及其95%置信区间表示的效应量。将对研究的异质性进行统计学评估。如有可能，将进行亚组分析以确定危险因素与高血压急症的关联。在无法进行统计合并的情况下，将以叙述形式呈现研究结果。
PROSPERO CRD42019140093。
