CLINICAL PROFILE AND OUTCOMES OF PATIENTS PRESENTING WITH HYPERTENSIVE EMERGENCIES TO THE EMERGENCY DEPARTMENT

Abstract

Background: Hypertensive emergencies are life-threatening conditions characterized by severe elevation of blood pressure with acute target-organ damage, requiring immediate diagnosis and prompt treatment. Limited data are available regarding their clinical profile and outcomes from tertiary care centers in central India. Materials and Methods: This hospital-based prospective observational study was conducted over 12 months in the emergency department of a tertiary care teaching hospital. A total of 320 adult patients presenting with hypertensive emergencies were enrolled. Demographic characteristics, clinical presentation, comorbidities, target-organ involvement, emergency management, and in-hospital outcomes were recorded and analyzed using appropriate descriptive and inferential statistical methods. Results: The mean age of the patients was 58.7 ± 14.2 years, and 60.6% were males. Previously diagnosed hypertension was present in 77.5% of patients, while 48.8% demonstrated poor treatment adherence. Headache (52.5%), dyspnea (36.9%), and chest pain (25.6%) were the most common presenting symptoms. Diabetes mellitus (36.3%) was the predominant comorbidity. Acute ischemic stroke (26.3%) was the commonest target-organ complication, followed by acute pulmonary edema (16.9%) and acute coronary syndrome (14.4%). Intravenous labetalol was the most frequently administered antihypertensive agent (45.6%). Overall, 70.6% of patients improved and were discharged, 19.4% required intensive care, and the in-hospital mortality rate was 4.4%. Advanced age, diabetes mellitus, chronic kidney disease, acute kidney injury, mechanical ventilation, and multiple-organ involvement were significantly associated with adverse clinical outcomes. Conclusion: Hypertensive emergencies predominantly affected patients with long-standing hypertension and poor treatment adherence, with neurological complications representing the most frequent manifestation. Early recognition, rapid blood pressure control, and prompt identification of high-risk patients with multiple-organ involvement and renal dysfunction are essential for improving outcomes and reducing mortality.