Management of Patients with Severe Hypertension
in Emergency Department,
Maharaj Nakorn Chiang Mai Hospital
Kamphee Sruamsiri MD*,
Boriboon Chenthanakij MD*, Borwon Wittayachamnankul MD*
Affiliation :
* Department of Emergency Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
Background : Management of patients with severe hypertension without progressive target organ damage remains
controversial. Some guidelines mentioned oral anti-hypertensive medication as a treatment to reduce blood pressure in the
emergency department, while others recommended against such treatment.
Objective : To review the management of patients with severe hypertension without progressive target organ damage in the
emergency department, Maharaj Nakorn Chiang Mai hospital.
Material and Method: In a retrospective descriptive analysis study, medical records of adult patients diagnosed with severe
hypertension without progressive target organ damage between January 2011 and December 2012 were reviewed. Patient
demographics, data on management including investigation sent and treatment given were collected. Statistical analysis
was done by using descriptive statistics and Kruskal-Wallis one-way analysis of variance test.
Results : One hundred fifty one medical records were reviewed. Four oral anti-hypertensive medication were used to reduce
blood pressure, Amlodipine, Captopril, Hydralazine, and Nifedipine. There were no significant difference between each
medication in terms of their effect on blood pressure reduction (p = 0.513). No side effect or other complications from the
use of oral anti-hypertensive medication were recorded.
Conclusion : The choice of medication used for the treatment of hypertensive urgency ranged from Amlodipine, Captopril,
Hydralazine, and Nifedipine, which varied in dosage. However, their efficacies were the same when compared with each
other, and none produced any notable side effects.
Keywords : Hypertensive urgency; Antihypertensive agents
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