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Prevalence of Hypertensive Emergency and Associated Factors Among Hospitalized Patients with Hypertensive Crisis: A Retrospective Cross-Sectional Study.

ABSTRACT: Background:Hypertensive emergency (HE) is an acute stage of uncontrolled blood pressure which poses a substantial cardiovascular morbidity and mortality in developing countries. In our setting, the prevalence of HE and the characteristics of patients with a hypertensive crisis are not certainly known yet. Objective:The study assessed the prevalence of hypertensive emergency and associated factors among hospitalized patients with hypertensive crisis. Methods:A retrospective cross-sectional study was conducted by reviewing records of patients having a diagnosis of hypertensive crisis with systolic/diastolic blood pressure raised to more than 180/120 mmHg admitted to Ayder Comprehensive Specialized Hospital (ACSH) from September 2018 to August 2019. Patients' medical records with complete information were enrolled consecutively. Socio-demographic, clinical characteristics, and other related variables were collected using a structured data collection tool from patient medical records. Data were entered and analyzed using SPSS version 20. Logistic regression was employed to determine factors associated with HE. Results:A total of 141 patients' records with a diagnosis of a hypertensive crisis were enrolled in the study; the majority were females 77 (54.6%) and residing in the urban setting 104 (73.8%). The mean age of the participants was 58.8 years. HE was found in 42 (29.8%) of patients. Intravenous Hydralazine 39 (27.7%) and oral calcium channel blocker 102 (72.3%) were the prescribed drugs for acute blood pressure reduction in the emergency setting. Surprisingly, patients who had no history of hypertension (adjusted odds ratio (AOR)=2.469; 95% confidence interval (CI): 0.176?0.933) and female sex (AOR=2.494; 95% CI: 1.111?5.596) were found to be independently associated factors with HE. Conclusion:The prevalence of HE was found to account a significant proportion of patients. Hence, hypertensive patients should be strictly managed accordingly, and promoting screening programs could reduce the risk of target organ damage.

SUBMITTER: Desta DM

PROVIDER: S-EPMC7455594 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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Prevalence of Hypertensive Emergency and Associated Factors Among Hospitalized Patients with Hypertensive Crisis: A Retrospective Cross-Sectional Study.

Desta Desilu Mahari DM Wondafrash Dawit Zewdu DZ Tsadik Afewerki Gebremeskel AG Kasahun Gebremicheal Gebreslassie GG Tassew Segen S Gebrehiwot Teklu T Asgedom Solomon Weldegebreal SW

Integrated blood pressure control 20200818

<h4>Background</h4>Hypertensive emergency (HE) is an acute stage of uncontrolled blood pressure which poses a substantial cardiovascular morbidity and mortality in developing countries. In our setting, the prevalence of HE and the characteristics of patients with a hypertensive crisis are not certainly known yet.<h4>Objective</h4>The study assessed the prevalence of hypertensive emergency and associated factors among hospitalized patients with hypertensive crisis.<h4>Methods</h4>A retrospective ...[more]

PMID: 32904390

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Project description:BackgroundHypertension (HTN) is a common comorbidity among diabetic patients. Studies reported that HTN prevalence in patients with diabetes mellitus (DM) depends on many risk factors related to the disease (the type and duration of DM), patients (age, sex, race/ethnicity, BMI), and medical history (glycemic control, renal problems). Best to our knowledge, limited evidence is available in this regard among Jordanian population.ObjectivesThis retrospective cross-sectional study aimed to determine the prevalence of HTN among patients with DM in Jordan and factors that might be associated with the concurrence of both diseases.Materials and methodsA cross-sectional study was conducted to determine HTN prevalence and risk factors among diabetic outpatients in Jordan. Patients were asked about their sociodemographic information and medical history. A descriptive analysis was used to determine HTN prevalence and a fit bivariate logistic regression model was used to identify the significant risk factors of HTN in patients with type 2 DM (T2DM).ResultsHTN was found to be concurrently occurring in approximately 80% of T2DM patients. This was found to increase with age. In addition, dyslipidemia, gout disease, ischemic heart disease, renal impairment, or a family history of HTN were found to be associated with the concurrence of HTN among T2DM patients.ConclusionFindings from this study highlight the need for proper monitoring of DM patients to reduce the co-occurrence of HTN. Specific attention should be directed to control the patients' glycemic and lipid profiles as well as the cardiac and renal health using non-pharmacological and pharmacological measures. This is of particular importance in T2DM patients at old age and with family history of HTN, to reduce patients' deterioration. Results from this study will also be informative for the development of public health strategies to increase the awareness of the general population regarding T2DM and HTN since both diseases are very common among Jordanian population.

Project description:ObjectivesThe health burden of chronic liver disease is increasing worldwide. Its main histological consequence is liver fibrosis, and eventually cirrhosis. This process is rarely diagnosed at the pre-cirrhotic stage due to it being asymptomatic. Little is known about the prevalence of liver fibrosis and associated risk factors in the general population. The aims of this study were to determine the prevalence and distribution of liver fibrosis using magnetic resonance elastography (MRE), as well as the risk factors associated with liver fibrosis in the asymptomatic general population.Design, setting and participantsThis cross-sectional retrospective study consecutively selected subjects who underwent health check-ups including MRE at 13 health promotion centres in Korea between 2018 and 2020. Liver fibrosis was estimated using MRE with cut-off values for significant and advanced liver fibrosis of 2.90 and 3.60 kPa, respectively.Primary and secondary outcome measuresThe Χ2 test was used to compare the prevalence of liver fibrosis according to sex and age groups. Multivariable logistic regression analyses were performed to identify the factors for significant and advanced liver fibrosis.ResultsAmong the 8183 subjects, 778 (9.5%) had ≥significant fibrosis (≥2.9 kPa), which included 214 (2.6%) subjects with ≥advanced fibrosis (≥3.6 kPa). Multivariable analysis revealed that liver fibrosis was associated with age (OR=1.34, 95% CI=1.18 to 1.51), male sex (OR=3.18, 95% CI=1.97 to 5.13), diabetes (OR=2.43, 95% CI=1.8 to 3.28), HBsAg positivity (OR=3.49, 95% CI=2.55 to 4.79), abnormal liver function test (OR=1.9, 95% CI=1.49 to 2.42) and obesity (OR=1.77, 95% CI=1.35 to 2.32) (all p<0.001), as well as metabolic syndrome (OR=1.4, 95% CI=1.05 to 1.87) (p=0.024).ConclusionsThe prevalence of significant or more liver fibrosis was high in the Korean general population and much higher among individuals with risk factors. This suggests that screening of liver fibrosis should be considered in general population, especially among high-risk groups.

Project description:BackgroundDespite the use of safe and effective conventional drugs, drug therapy problems (DTPs) pose a threat to the successful management of hypertension. DTPs are of a great concern in health care because of their serious consequences such as poor quality of life, increased health care costs, morbidity and mortality. However, there is no published information regarding the prevalence of DTPs and associated factors among hypertensive patients in Uganda.ObjectiveThe aim of the study was to determine the prevalence and factors associated with DTPs among hypertensive patients at the hypertension clinic of Mbarara Regional Referral Hospital (MRRH).MethodA cross-sectional study was conducted at the hypertension clinic, MRRH, Uganda among 228 hypertensive patients. Data were collected from medical records using a data abstraction tool and patients were interviewed using a structured questionnaire. Data analysis was done using Statistical Package for Social Sciences (SPSS) version 22.0. Descriptive analysis was used to determine the prevalence of DTPs. Logistic regression was used to determine the association between the independent and dependent variables. Variables were considered statistically significant at p-value <0.05.ResultsA total of 178 DTPs were identified among 141 hypertensive patients. The prevalence of antihypertensive-related DTPs was 61.8% (95% confidence interval [CI]: 55.3-67.5) with an average of 1.26 ± 0.52 DTPs per patient. Out of 141 participants with DTPs, 109 (77.3%) had one DTP, 27 (19.1%) had 2 DTPs, and 5 (3.5%) had 3 DTPs. The most common types of antihypertensive-related DTPs were 'dosage too low' which accounted for 53 (29.8%), followed by 'adverse drug reactions' which accounted for 48 (27%). Uncontrolled blood pressure (BP; adjusted odds ratio [AOR]: 4.17; 95% CI: 2.33-7.45, p < 0.001) and routine laboratory test results (AOR: 1.87; 95% CI: 1.04-3.36, p = 0.036) were significantly associated with antihypertensive-related DTPs among hypertensive patients.ConclusionAlmost two-thirds of study participants had antihypertensive-related DTPs. The most common DTPs were 'dosage too low' and 'adverse drug reactions' which both accounted for almost a third of the total DTPs each. Uncontrolled BP and routine laboratory test results were significantly associated with antihypertensive-related DTPs among the study participants. Our study emphasizes the need for improved patient care by clinical pharmacists to identify and prevent DTPs among hypertensive patients.

Project description:OBJECTIVES:The aim of this study was to describe the carrier prevalence and demographic variation of four different multiresistant bacteria (MRB) among acute patients in Danish emergency departments (EDs): methicillin-resistant Staphylococcus aureus (MRSA), carbapenemase-producing enterobacteria (CPE), extended-spectrum beta-lactamase-producing enterobacteria (ESBL) and vancomycin-resistant enterococci (VRE), and to analyse the association of MRB carriage to a range of potential risk factors. DESIGN:Multicentre descriptive and analytic cross-sectional survey. SETTING:Eight EDs and four clinical microbiology departments in Denmark. PARTICIPANTS:Adults visiting the ED. MAIN OUTCOME MEASURES:Swabs from nose, throat and rectum were collected and analysed for MRSA, ESBL, VRE and CPE. The primary outcome was the prevalence of MRB carriage, and secondary outcomes relation to risk factors among ED patients. RESULTS:We included 5117 patients in the study. Median age was 68 years (54-77) and gender was equally distributed. In total, 266 (5.2%, 95% CI 4.6 to 5.8) were colonised with at least one MRB. No significant difference was observed between male and female patients, between age groups and between university and regional hospitals. Only 5 of the 266 patients with MRB were colonised with two of the included bacteria and none with more than two. CPE prevalence was 0.1% (95% CI 0.0 to 0.2), MRSA prevalence was 0.3% (95% CI 0.2 to 0.5), VRE prevalence was 0.4% (95% CI 0.3 to 0.6) and ESBL prevalence was 4.5% (95% CI 3.9 to 5.1). Risk factors for MRB carriage were previous antibiotic treatment, previous hospital stay, having chronic respiratory infections, use of urinary catheter and travel to Asia, Oceania or Africa. CONCLUSION:Every 20th patient arriving to a Danish ED brings MRB to the hospital. ESBL is the most common MRB in the ED. The main risk factors for MRB carriage are recent antibiotic use and travel abroad. TRIAL REGISTRATION NUMBER:NCT03352167;Post-results.

Dataset Information

Prevalence of Hypertensive Emergency and Associated Factors Among Hospitalized Patients with Hypertensive Crisis: A Retrospective Cross-Sectional Study.

Publications

Prevalence of Hypertensive Emergency and Associated Factors Among Hospitalized Patients with Hypertensive Crisis: A Retrospective Cross-Sectional Study.

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