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Practice patterns, outcomes, and end-organ dysfunction for patients with acute severe hypertension: the Studying the Treatment of Acute hyperTension (STAT) registry.

Abstract：

BACKGROUND:Limited data are available on the care of patients with acute severe hypertension requiring hospitalization. We characterized contemporary practice patterns and outcomes for this population. METHODS:STAT is a 25-institution, US registry of consecutive patients with acute severe hypertension (>180 mm Hg systolic and/or >110 mm Hg diastolic; >140 and/or >90 for subarachnoid hemorrhage) treated with intravenous therapy in a critical care setting. RESULTS:One thousand five hundred eighty-eight patients were enrolled (January 2007 to April 2008). Median age was 58 years (interquartile range 49-70 years), 779 (49%) were women, and 892 (56%) were African American; 27% (n = 425) had a prior admission for acute hypertension and 486 (31%) had chronic kidney disease. Median qualifying blood pressure (BP) was 200 (186, 220) systolic and 110 (93, 123) mm Hg diastolic. Initial intravenous antihypertensive therapies used to control BP varied, with 1,009 (64%) patients requiring multiple drugs. Median time to achieve a systolic BP <160 mm Hg (<140 mm Hg for subarachnoid hemorrhage) was 4.0 (0.8, 12) hours; 893 (60%) had reelevation to >180 (>140 for subarachnoid hemorrhage) after initial control; and 63 (4.0%) developed iatrogenic hypotension. Hospital mortality was 6.9% (n = 109) with an aggregate 90-day mortality rate of 11% (174/1,588); 59% (n = 943) had acute/worsening end-organ dysfunction during hospitalization. The 90-day readmission rate was 37% (523/1,415), of which one quarter (132/523) was due to recurrent acute severe hypertension. CONCLUSION:This study highlights heterogeneity in care, BP control, and outcomes of patients hospitalized with acute severe hypertension.

journal_name

Am Heart J

journal_title

American heart journal

authors

Katz JN,Gore JM,Amin A,Anderson FA,Dasta JF,Ferguson JJ,Kleinschmidt K,Mayer SA,Multz AS,Peacock WF,Peterson E,Pollack C,Sung GY,Shorr A,Varon J,Wyman A,Emery LA,Granger CB,STAT Investigators.

doi

10.1016/j.ahj.2009.07.020

subject

Has Abstract

pub_date

2009-10-01 00:00:00

pages

599-606.e1

issue

eissn

0002-8703

issn

1097-6744

pii

S0002-8703(09)00547-X

journal_volume

158

pub_type

杂志文章,多中心研究

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Practice patterns, outcomes, and end-organ dysfunction for patients with acute severe hypertension: the Studying the Treatment of Acute hyperTension (STAT) registry.