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BMC Cardiovascular Disorders

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Open Access 01-12-2024 | Hypertension | Research

In emergency hypertension, could biomarkers change the guidelines?

Authors: Mohammad El Tahlawi, Scopus Mohamed Ismail, Ahmed Eldamanhory, Ayman Khorshed, Salem M. Salem

Published in: BMC Cardiovascular Disorders | Issue 1/2024

Abstract

Background

Hypertension may cause target organ damage (TOD). Target blood pressure (BP) management may not be appropriate in some conditions.

Aim

We aim to assess the impact of targeted BP management in severe hypertension on renal TOD.

Patients & methods

This is a prospective cohort study involving patients admitted due to severe hypertension (BP > 180/120) associated with any symptoms. The study involved patients referred to the ICU in our tertiary center during the period between August 2017 and February 2018. All patients underwent target BP treatment according to recent guidelines. Hs-Troponin T (hs-TNT) and serum creatinine (s.creat) were measured in all patients on admission and 24 h later. Patients were divided into Group A (with initial normal hs-TNT) and Group B (with initial high hs-TNT). The main outcome was in-hospital renal-related morbidity (including renal failure).

Results

Four hundred seventy consecutive patients with hypertensive crises were involved in the study. Group B had a significantly higher incidence of in-hospital mortality (4 patients) and renal TOD (acute renal dysfunction) than Group A (P value = 0.001 and 0.000 respectively). There was a significant difference between initial s.creat on admission and follow-up s.creat values in Group B with significant elevation of their s.creat on the following 24 h (P = 0.002), while this difference is insignificant in Group A (P = 0.34). There was a significant positive correlation between hs-TNT and the follow-up s.creat (P = 0.004).

Conclusion

In severe HTN, hs-TNT may be elevated due to marked afterload. Patients with severe HTN and high hs-TNT have higher s.creat values, which are associated with an increased risk of renal failure and in-hospital mortality if their BP decreases acutely to the guideline-target BP. Using biomarkers during the management of emergency HTN should be considered before following clinical guidelines. However, our findings do underscore the potential utility of hs-TNT as an indicator for risk stratification in patients with severe or emergency HTN.

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Title: In emergency hypertension, could biomarkers change the guidelines?
Authors: Mohammad El Tahlawi
Scopus Mohamed Ismail
Ahmed Eldamanhory
Ayman Khorshed
Salem M. Salem
Publication date: 01-12-2024
Publisher: BioMed Central
Keywords: Hypertension
Hypertension
Biomarkers
Published in: BMC Cardiovascular Disorders / Issue 1/2024
Electronic ISSN: 1471-2261
DOI: https://doi.org/10.1186/s12872-024-03785-3

2024 ASCO Annual Meeting

Springer Medicine

In emergency hypertension, could biomarkers change the guidelines?

Abstract

Background

Aim

Patients & methods

Results

Conclusion

2024 ASCO Annual Meeting

Springer Medicine

Abstract

Background

Aim

Patients & methods

Results

Conclusion

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