Gezie Hailemariam, Azazh Aklilu, Melaku Birhanu, Gelaye Habtam
Department of Emergency and Critical Care Nursing, School of Nursing and Midwifery, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia.
Department of Emergency Medicine, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
Int J Emerg Med. 2023 Oct 9;16(1):68. doi: 10.1186/s12245-023-00549-2.
Hypertension (HTN) is a major global health problem that affects approximately 1.13 billion people worldwide, and 1-2% of this population has hypertensive crisis. Hypertensive crisis is becoming a major health issue in low-income countries. However, few studies have been conducted in developing countries such as Ethiopia. This study aimed to assess the determinants of hypertensive crisis among patients visiting adult emergency departments of public hospitals in Addis Ababa.
A hospital-based unmatched case-control study was conducted among 85 cases with a hypertensive crisis and 170 controls with hypertension without a hypertensive crisis in the adult emergency departments of public hospitals in Addis Ababa from March 15 to May 15, 2021. Data were collected using a structured questionnaire and analyzed using SPSS version 26. Binary logistic regression and multivariable logistic regression were performed. Finally, a statistically significant level was declared at a p value of less than 0.05. The result was summarized and presented in text, tables, and graph.
The odds of having hypertensive crisis were 3.6 times (AOR = 3.621) higher among participants with a history of hypertension compared to those without a history of hypertension. There was also 4 times increased risk of hypertensive crisis among participants who presented with diabetes mellitus than participants who presented without it (AOR = 4.179). Similarly, participants who presented with stroke had 7 times higher odds of having hypertensive crisis (AOR = 7.174) than participants without stroke.
This study demonstrated a statistically significant association between unemployment, diabetes mellitus, stroke, heart failure, history of hypertension, family history of hypertension, and regular follow-up with a hypertensive crisis. The Ethiopian Ministry of Health, Ababa City Administration Health Bureau, and hospitals shall give due attention to the HTN crisis. Health care workers, hospital managers, and other stakeholders shall work towards the early detection and management of HTN-crisis to prevent related morbidity, disability, and mortality.
高血压是一个重大的全球健康问题，全球约有11.3亿人受其影响，其中1%-2%的人患有高血压危象。高血压危象正成为低收入国家的一个主要健康问题。然而，在埃塞俄比亚等发展中国家开展的研究较少。本研究旨在评估亚的斯亚贝巴公立医院成人急诊科就诊患者中高血压危象的决定因素。
2021年3月15日至5月15日，在亚的斯亚贝巴公立医院成人急诊科对85例高血压危象患者和170例无高血压危象的高血压患者进行了一项基于医院的非匹配病例对照研究。使用结构化问卷收集数据，并使用SPSS 26版进行分析。进行二元逻辑回归和多变量逻辑回归。最后，p值小于0.05时宣布具有统计学显著性水平。结果以文字、表格和图表形式进行总结和呈现。
有高血压病史的参与者发生高血压危象的几率比无高血压病史的参与者高3.6倍（调整后比值比[AOR]=3.621）。患有糖尿病的参与者发生高血压危象的风险比未患糖尿病的参与者增加4倍（AOR=4.179）。同样，发生中风的参与者发生高血压危象的几率比未发生中风的参与者高7倍（AOR=7.174）。
本研究表明，失业、糖尿病、中风、心力衰竭、高血压病史、高血压家族史以及定期随访与高血压危象之间存在统计学上的显著关联。埃塞俄比亚卫生部、亚的斯亚贝巴市行政卫生局和医院应给予高血压危象应有的关注。医护人员、医院管理人员和其他利益相关者应努力早期发现和管理高血压危象，以预防相关的发病率、残疾和死亡率。
