0
Abstract: Poster Presentations |

HETEROGENEOUS MANAGEMENT OF ACUTE SEVERE HYPERTENSION IS ASSOCIATED WITH HIGH MORBIDITY AND MORTALITY: RESULTS FROM STUDYING THE TREATMENT OF ACUTE HYPERTENSION (STAT) REGISTRY FREE TO VIEW

Joel M. Gore, MD*; Jason N. Katz, MD; Frederick A. Anderson, PhD; Kurt Kleinschmidt, MD; Allison Wyman, MS; Christopher B. Granger, MD
Author and Funding Information

UMASS Medical School, Worcester, MA


Chest


Chest. 2008;134(4_MeetingAbstracts):p42003. doi:10.1378/chest.134.4_MeetingAbstracts.p42003
Text Size: A A A
Published online

Abstract

PURPOSE: Studying the Treatment of Acute hyperTension (STAT) is a multicenter observational study of patients with acute severe hypertension (HTN) treated with IV antihypertensive therapy in critical care settings.

METHODS: Medical records were abstracted from patients treated between January 1 and December 31, 2007. Data were collected for 1599 patients from 25 hospitals.

RESULTS: The patients’ median age was 58 years, 49% were women, and 56% were black (vs 34% white). The median (Q1,Q3) qualifying BP was 200 mmHg (186,220) systolic and 110 (93, 123) diastolic. Most (88%) had a history of HTN, 35% had diabetes, 31% had chronic kidney disease, and 15% had a history of drug abuse. Medication non-compliance was a common (25%) predisposing factor. One quarter of patients had a prior hospitalization for severe HTN. The most common presenting symptoms were dyspnea (29%) and chest pain (26%). 77% had IV antihypertensive therapy begun in the emergency department. Presenting conditions and management are shown in the table. Median time to achieve a SBP <160 mmHg was 4.0 h, 61% had re-elevation to >=180 after initial control, and 5% developed iatrogenic hypotension (for patients with admitting diagnosis of subarachnoid hemorrhage, cutpoints of <140 and >=140 mmHg were used). 77% of patients had some degree of end-organ injury evident during hospitalization. Patients were discharged on a median of 2 antihypertensive drugs; 15% had no documentation of follow-up instructions or an appointment being scheduled, and 57% had no documented follow-up visit up to 90 days. Mortality at 90 days was 8.8%, 35% of patients were rehospitalized, one quarter of whom were rehospitalized for acute severe HTN.

CONCLUSION: STAT provides a contemporary view in a large, multicenter study of patients presenting with acute severe HTN. Our data show heterogeneity of management and blood pressure control and high short-term morbidity and mortality of this understudied condition.

CLINICAL IMPLICATIONS: There are significant opportunities for improvement in processes of care in the treatment of acute severe HTN.

DISCLOSURE: Joel Gore, No Financial Disclosure Information; No Product/Research Disclosure Information

Tuesday, October 28, 2008

1:00 PM - 2:15 PM


Figures

Tables

References

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Some tools below are only available to our subscribers or users with an online account.

Related Content

Customize your page view by dragging & repositioning the boxes below.

Find Similar Articles
CHEST Journal Articles
PubMed Articles
  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543