Buea Regional Hospital, Buea, Cameroon.
Clinical Research Education, Networking and Consultancy, Douala, Cameroon.
J Clin Hypertens (Greenwich). 2020 Nov;22(11):2105-2110. doi: 10.1111/jch.14035. Epub 2020 Sep 20.
Hypertensive crisis (HC) includes hypertensive urgency (HU) and hypertensive emergency (HE). There is scarcity of data on the epidemiology of patients presenting with HC in Cameroon. The aim of this study was to determine the prevalence, clinical characteristics, and outcome of HU and HE. We conducted a cross-sectional study from June 2018 until June 2019. The criteria to define a hypertensive crisis were systolic and/or diastolic blood pressure ≥180/110 mm Hg. We compared HU vs HE. Out of the 1536 patients admitted, 95(6.2%) had a HC. There were 49(51.6%) men and 56 (58.9%) had a HE. The mean age was 51.1 ± 14.9 years. A history of hypertension was found in 75.3% of the patients but only 24.2% were on treatment. 33.7% consumed alcohol and 24.2% had chronic kidney disease. Headache (34.7%), dyspnea (34.7%), and neurological deficit (23.2%) were the most common symptoms. Patients with HE had higher systolic and diastolic blood pressures though the difference was not significant. The most frequent forms of HE were acute left ventricular failure with pulmonary edema (44.6%), intracerebral hemorrhage (21.4%), and cerebral infarction (16.1%). The most commonly prescribed medication was labetalol (44.2%). Mean length of hospital stay was 8.4 days. Patients with HE had a longer hospital stay (9.8 vs 6.3 days, P < .001). In-hospital case fatality was 6.3%. Hypertensive crisis accounted for 6.2% of admissions in the medical unit with HE being more common than HU. Acute left ventricular failure with pulmonary edema and stroke were the most frequent target organ lesions in HE.
高血压危象(HC)包括高血压急症(HU)和高血压亚急症(HE)。喀麦隆高血压危象患者的流行病学数据匮乏。本研究旨在确定 HU 和 HE 的患病率、临床特征和结局。我们于 2018 年 6 月至 2019 年 6 月开展了一项横断面研究。高血压危象的定义标准为收缩压和/或舒张压≥180/110mmHg。我们比较了 HU 与 HE。在 1536 例住院患者中,有 95 例(6.2%)发生 HC。其中 49 例(51.6%)为男性,56 例(58.9%)为 HE。平均年龄为 51.1±14.9 岁。75.3%的患者有高血压病史,但仅有 24.2%的患者接受治疗。33.7%的患者饮酒,24.2%的患者患有慢性肾病。头痛(34.7%)、呼吸困难(34.7%)和神经功能缺损(23.2%)是最常见的症状。HE 患者的收缩压和舒张压更高,但差异无统计学意义。HE 最常见的形式是急性左心衰竭伴肺水肿(44.6%)、脑出血(21.4%)和脑梗死(16.1%)。最常开的药物是拉贝洛尔(44.2%)。平均住院时间为 8.4 天。HE 患者的住院时间更长(9.8 天 vs 6.3 天,P<.001)。住院期间病死率为 6.3%。高血压危象占内科住院患者的 6.2%,HE 比 HU 更常见。急性左心衰竭伴肺水肿和脑卒中是 HE 最常见的靶器官损伤。