Wondimneh Fenta, Getachew Melaku, Teshager Tilahun, Legesse Henok, Alemu Ayichew, Ketema Indeshaw, Tesfaye Dejene, Mossie Yalew, Muluberhan Natan, Meseret Fentahun
Department of Emergency and Critical Care Nursing, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia.
Department of Emergency and Critical Care Medicine, School of Medicine, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia.
PLoS One. 2025 Jun 16;20(6):e0326055. doi: 10.1371/journal.pone.0326055. eCollection 2025.
Hypertensive crisis is a life-threatening condition requiring urgent medical intervention. Identifying key determinants is essential for effective prevention and management. This study aimed to assess factors associated with hypertensive crisis among patients attending selected public hospitals in eastern Ethiopia.
A hospital-based unmatched case-control study was conducted among 357 participants (119 cases and 238 controls). Cases were hypertensive crisis patients, while controls were hypertensive patients without crisis in adult emergency departments of public hospitals in eastern Ethiopia from April 10th to September 10th, 2023. Data were collected using structured questionnaires and medical record reviews. Multivariable logistic regression was used to identify independent determinants of hypertensive crisis, with results presented as Adjusted Odds Ratios (AORs) and 95% Confidence Intervals (CIs).
The mean age of participants was 54.7 ± 14.4 years for cases and 48.14 ± 15.51 years for controls. More than half of the cases (54.8%) and one-third of the controls (32.6%) were female. Multivariable analysis identified female sex (AOR = 2.91, 95% CI: 1.67-5.07), unemployment (AOR = 2.28, 95% CI: 1.20-4.33), diabetes mellitus (AOR = 3.33, 95% CI: 1.59-7.01), previous history of hypertension (AOR = 2.25, 95% CI: 1.21-4.19), drinking alcohol (AOR = 3.01, 95% CI: 1.45-6.24), and poor knowledge of hypertension (AOR = 1.86, 95% CI: 1.07-3.22) as significant determinants of hypertensive crisis (p < 0.05).
Female sex, unemployment, diabetes mellitus, history of hypertension, drinking alcohol, and poor hypertension knowledge were independent predictors of hypertensive crisis. However, the case-control design's intrinsic limitations make it difficult to establish a temporal relationship between risk factors and outcomes. Strengthening hypertension education, promoting lifestyle modifications, and enhancing healthcare access may help mitigate the risk of hypertensive crisis.
高血压危象是一种危及生命的疾病，需要紧急医疗干预。确定关键决定因素对于有效预防和管理至关重要。本研究旨在评估埃塞俄比亚东部选定公立医院就诊患者中与高血压危象相关的因素。
在357名参与者（119例病例和238名对照）中进行了一项基于医院的非匹配病例对照研究。病例为高血压危象患者，对照为2023年4月10日至9月10日埃塞俄比亚东部公立医院成人急诊科中无危象的高血压患者。使用结构化问卷和病历审查收集数据。多变量逻辑回归用于确定高血压危象的独立决定因素，结果以调整后的优势比（AOR）和95%置信区间（CI）表示。
病例组参与者的平均年龄为54.7±14.4岁，对照组为48.14±15.51岁。超过一半的病例（54.8%）和三分之一的对照（32.6%）为女性。多变量分析确定女性（AOR = 2.91，95% CI：1.67 - 5.07）、失业（AOR = 2.28，95% CI：1.20 - 4.33）、糖尿病（AOR = 3.33，95% CI：1.59 - 7.01）、既往高血压病史（AOR = 2.25，95% CI：1.21 - 4.19）、饮酒（AOR = 3.01，95% CI：1.45 - 6.24）以及高血压知识匮乏（AOR = 1.86，95% CI：1.07 - 3.22）是高血压危象的重要决定因素（p < 0.05）。
女性、失业、糖尿病、高血压病史、饮酒以及高血压知识匮乏是高血压危象的独立预测因素。然而，病例对照设计的内在局限性使得难以确定危险因素与结局之间的时间关系。加强高血压教育、促进生活方式改变以及改善医疗服务可有助于降低高血压危象的风险。
