Factors Associated with Successful Blood Pressure Control in Hypertensive Urgency Patients after 12-Week Treatment
Khamphukaew T, MD1, Mitsungnern T, MD2, Imoun S, MNS3, Kotruchin P, MD, PhD2
Affiliation : 1 Emergency Medicine Unit, Nongbualamphu Hospital, Nongbualamphu, Thailand 2 Department of Emergency Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand 3 Department of Emergency Nursing, Srinagarind Hospital, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
Background : Hypertensive urgency is a common presentation in the emergency room (ER). Current practice guidelines suggest
that it is not necessary to meet a strict blood pressure (BP) target in ER. But patients should achieve the BP goal within weeks or
a few months. However, there is limited data on the follow-up BP outcome and its determinants.
Objective : To evaluate factors associated with successful BP control for hypertensive urgency patients after a 12-week treatment.
Materials and Methods: A retrospective cohort study conducted at a university hospital in the Northeast of Thailand from 1st
January 2012 to 31st December 2016. We enrolled hypertensive urgency patients who visited ER and received standard treatment
and followed-up in the Hypertensive Crisis Clinic for 12 weeks.
Results : A successful BP control (<140/90 mmHg) was observed in 129 patients (56.1%). The factor that associated with a successful
BP control was the achievement of three-lifestyle modification including medication adherence, aerobic exercise, and salt restriction
(OR 1.79; 95% CI, 1.01 to 3.19; p = 0.048), not the baseline BP, number of medication, and underlying diseases.
Conclusion : Lifestyles modification was an effective strategy to achieve a targeted BP in the hypertensive urgency patient. Therefore,
patients should be educated and encouraged to have healthy lifestyles.
Keywords : Hypertensive crisis, Emergency, Lifestyles modification, Thai, Salt restriction
