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Abstract: TH-PO599

Adherence to Guidelines for Management of Hypertensive Emergency

Session Information

Category: Hypertension and CVD

  • 1501 Hypertension and CVD: Epidemiology‚ Risk Factors‚ and Prevention

Authors

  • Ghazi, Lama, Yale University, New Haven, Connecticut, United States
  • Nugent, James, Yale University, New Haven, Connecticut, United States
  • Victoria Castro, Angela Maria, Yale University, New Haven, Connecticut, United States
  • Wilson, Francis Perry, Yale University, New Haven, Connecticut, United States
Background

Hypertensive emergencies, severe blood pressure (BP) elevation >180/120 associated with end organ damage, are associated with increased mortality. Rates of hospitalization for hypertensive emergencies have increased over the past 10 years especially among Black adults. We assessed the adherence to BP reduction goals for hypertensive emergency and the rates by race.

Methods

This is a retrospective study of patients admitted for hypertensive emergency from 2016-2018 within the Yale New Haven Health System. We used International Classification of Diseases codes, labs and manual chart review to assess end organ damage. We then calculated percent adherence to BP reduction goals set by 2017 American College of Cardiology/American Heart Association guidelines in all patients and by race.

Results

We identified 596 patients admitted for hypertensive emergency. Patients were 65 ± 16 years, 50% male, 43% Black with median BP on admission of 207 [193, 226]/ 110 [94, 126] mmHg. Most patients were admitted with ischemic stroke followed by pulmonary edema (Table 1). BP reduction goals were not achieved among most patients at 6 hours and 24 hours regardless of end organ damage type. Black adults are less likely to achieve BP reduction for patients with hypertensive emergency and acute coronary syndrome (ACS) or hemorrhagic stroke (Figure 1).

Conclusion

Adherence to BP guidelines in treatment of patients admitted for hypertensive emergency was found to be suboptimal. Black patients with ACS and ischemic stroke had lower rates of BP control. Future efforts should focus on understanding the reasons behind the lack of guideline adherence and racial inequities in treatment.