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Clinical Research in Cardiology

Published in:

01-08-2013 | Original Paper

Heart rate differentiates urgency and emergency in hypertensive crisis

Authors: Rashed Al Bannay, Michael Böhm, Aysha Husain

Published in: Clinical Research in Cardiology | Issue 8/2013

Abstract

Objective

To study the clinical significance of presenting blood pressure parameters and heart rate in patients with hypertensive crisis.

Methods

In patients admitted with hypertensive crisis between January 2011 and May 2011, demography, mode of presentation, co-morbidities, blood pressure readings, and heart rate at presentation were documented. Further clustering of hypertensive crisis into emergency or urgency was based on the presence or absence of target organ involvement. The relationship between blood pressure parameters, heart rate, and other variables was analyzed.

Results

189 patients in sinus rhythm were enrolled in this pilot study. The rate of hypertensive urgency was 56 %, whereas the rate of hypertensive emergency was 44 %, respectively. Subjects with hypertensive emergency had a higher mean heart rate (93 ± 22.7 bpm) than those with urgency (81 ± 11.5 bpm) (P = 0.015). Women had higher heart rates (92 ± 18.5 bpm) than men (86 ± 17.6 bpm) (P = 0.014). Heart rates below 100 bpm had a specificity of 94 %, classifying patients as hypertensive urgency. Tachycardia had a powerful statistical association with hypertensive left ventricular failure (P < 0.0001). Other hemodynamic parameters, including systolic blood pressure, diastolic blood pressure, pulse pressure, and mean blood pressure relates neither to urgency nor to emergency. Diabetic patients with HBA1c levels of more than 53 mmol/mol had a heart rate of more than 100 bpm (P = 0.015) during hypertensive crisis.

Conclusions

Normal heart rate is characteristic of hypertensive urgency. Tachycardia in this setting is an ominous sign and denotes hypertensive complications in particular left ventricular failure. Among diabetics, elevated heart rate is associated with poor glycemic control.

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Title: Heart rate differentiates urgency and emergency in hypertensive crisis
Authors: Rashed Al Bannay
Michael Böhm
Aysha Husain
Publication date: 01-08-2013
Publisher: Springer Berlin Heidelberg
Published in: Clinical Research in Cardiology / Issue 8/2013
Print ISSN: 1861-0684
Electronic ISSN: 1861-0692
DOI: https://doi.org/10.1007/s00392-013-0570-5

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Heart rate differentiates urgency and emergency in hypertensive crisis

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Methods

Results

Conclusions

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