Alhasan Dalal, Yaseen Ameen
Department of Applied Medical Sciences, College of Health Sciences, Public Authority of Applied Education and Training, Kuwait, Kuwait.
Audit Department, Emergency Medical Services, Ministry of Health, Kuwait, Kuwait.
Open Access Emerg Med. 2021 Feb 26;13:75-81. doi: 10.2147/OAEM.S293413. eCollection 2021.
The objective of this study is to describe the characteristics of hypertensive emergencies in Kuwait aiming to provide a preliminary background to update the current guidelines and improve patients' management.
This is a prospective analysis of hypertensive emergency cases retrieved from emergency medical services (EMS) archived data between 1 January - 30 June 2020. Collected variables included patient characteristics, clinical presentations, vital signs, interventions, and complications. Outcome variable collected was: en route complications.
Hypertensive emergency prevalence in Kuwait is 4.75 per 100,000. Most were non-Kuwaiti (62%) males (59%) with a mean age of 57 ±14 years. Most hypertensive emergency cases occurred at home (62%). The hypertensive emergency BP threshold was; SBP 182 (SD=31) and diastolic BP (DBP) 108 (SD=18). 36% of hypertensive emergency cases had silent hypertension. 67% of hypertensive emergencies were verified using ambulance verification tools. Nitroglycerin was administered to only hypertensive emergencies suspected to have acute coronary syndrome or acute heart failure (50%). Complications were seen in 9.5% of hypertensive emergency cases.
Hypertensive emergency is rare in the ambulance but can progress into a serious situation. One in every 10 hypertensive emergency cases will require en route resuscitation. Hypertensive emergencies should be recognized and managed within their clinical context. The most common clinical presentation of hypertensive emergency is cardiac chest pain. Some pre-hospital verification tools confirm acute HMOD. Further research is required to establish hypertension emergency recognition and management guidelines in the prehospital setting.
本研究的目的是描述科威特高血压急症的特征，旨在提供初步背景信息，以更新当前指南并改善患者管理。
这是一项对2020年1月1日至6月30日从紧急医疗服务（EMS）存档数据中检索到的高血压急症病例的前瞻性分析。收集的变量包括患者特征、临床表现、生命体征、干预措施和并发症。收集的结果变量是：途中并发症。
科威特高血压急症的患病率为每10万人4.75例。大多数是非科威特人（62%）、男性（59%），平均年龄为57±14岁。大多数高血压急症病例发生在家中（62%）。高血压急症的血压阈值为：收缩压182（标准差=31），舒张压108（标准差=18）。36%的高血压急症病例存在无症状性高血压。67%的高血压急症通过救护车核查工具得到证实。仅对疑似患有急性冠状动脉综合征或急性心力衰竭的高血压急症患者使用硝酸甘油（50%）。9.5%的高血压急症病例出现并发症。
高血压急症在救护车中很少见，但可能发展为严重情况。每10例高血压急症病例中就有1例需要在途中进行复苏。应在临床背景下识别和管理高血压急症。高血压急症最常见的临床表现是心前区疼痛。一些院前核查工具可确认急性高血压性心、脑、肾损害（HMOD）。需要进一步研究以制定院前环境中高血压急症的识别和管理指南。
