Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Department of Pharmacy, Nordic Medical Centre As Ethiopian Branch, Addis Ababa, Ethiopia.
J Clin Hypertens (Greenwich). 2020 Dec;22(12):2343-2353. doi: 10.1111/jch.14056. Epub 2020 Sep 23.
Despite major public health initiatives are working in the control of hypertension, hypertensive crisis remains an important clinical problem. This study aimed at examining the characteristics, treatment and outcome of patients with hypertensive crisis admitted to the University of Gondar Specialized Hospital, Ethiopia. A cross-sectional study was conducted on patient medical records (n = 304) between January 01, 2013 and December 31, 2017. Data were analyzed using Statistical Package for Social Sciences version21. A total of 252 patient medical records were included in the analysis. The mean age of the entire patients was 54 ± 17 years. Two hundred and nineteen (86.9%) patients have a documented history of hypertension and on antihypertensive drugs (n = 166, 65.9%). The majority of cases (n = 166, 65.9%) were hypertensive urgencies. In more than one-third of the patients (n = 98, 38.9%), the cause of the illness was attributed to non-compliance to therapy. The most common presenting signs and symptoms at admission were headache (n = 170, 67.5%), dyspnea (n = 36, 14.3%), and vomiting (n = 33, 13.1%). Of 852 tests ordered, the results of one-third (n = 298,34.9%) were abnormal. Nearly two-thirds (n = 336, 59.2%) of prescriptions documented were for hypertensive urgency. Captopril (n = 136, 23.9%) and hydralazine (n = 43, 7.6%) were the most commonly prescribed oral and intravenous drugs respectively. Ten patients died during 55 hours of hospital stay. All hospital mortalities were documented for a hypertensive emergency. The median decrement of diastolic blood pressure among patients with no history of previous admission and hypertensive urgency was significantly higher than those patients with a previous history of admission (P = .005) and hypertensive emergency (P = .010). These findings justify better treatment and follow-up for these patients. Most importantly, to improve compliance with treatment health professionals should provide education to the patients.
尽管在控制高血压方面已经有了重大的公共卫生举措，但高血压危象仍然是一个重要的临床问题。本研究旨在检查在埃塞俄比亚贡德尔大学专科医院就诊的高血压危象患者的特征、治疗和结局。2013 年 1 月 1 日至 2017 年 12 月 31 日，对患者病历（n=304）进行了横断面研究。数据使用社会科学统计软件包版本 21 进行分析。共有 252 份患者病历纳入分析。所有患者的平均年龄为 54±17 岁。219 名（86.9%）患者有高血压病史和服用抗高血压药物（n=166，65.9%）。大多数病例（n=166，65.9%）为高血压急症。超过三分之一的患者（n=98，38.9%）的病因归咎于不遵医嘱。入院时最常见的体征和症状为头痛（n=170，67.5%）、呼吸困难（n=36，14.3%）和呕吐（n=33，13.1%）。在开的 852 项检查中，三分之一（n=298，34.9%）的结果异常。近三分之二（n=336，59.2%）的处方为高血压急症治疗。卡托普利（n=136，23.9%）和肼屈嗪（n=43，7.6%）分别是最常用的口服和静脉内药物。10 名患者在 55 小时的住院期间死亡。所有医院死亡均记录为高血压急症。无既往住院和高血压急症病史的患者舒张压下降中位数显著高于有既往住院和高血压急症病史的患者（P=0.005）和高血压急症（P=0.010）。这些发现证明需要对这些患者进行更好的治疗和随访。最重要的是，为了提高治疗依从性，卫生专业人员应向患者提供教育。
