scholarly journals Association of normal systolic blood pressure in the emergency department with higher in‐hospital mortality among hypertensive patients

2019 ◽  
Vol 21 (12) ◽  
pp. 1841-1848 ◽  
Author(s):  
Eyal Klang ◽  
Shelly Soffer ◽  
Moni Shimon Shahar ◽  
Yiftach Barash ◽  
Sara Apter ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Emergency Department ◽  
Hospital Mortality ◽  
Systolic Blood Pressure ◽  
Hypertensive Patients

The association between systolic blood pressure and in-hospital mortality in older emergency department patients who are hospitalised with a suspected infection

2018 ◽  
Vol 35 (10) ◽  
pp. 619-622 ◽  
Author(s):  
Mats Warmerdam ◽  
Lucia Baris ◽  
Margo van Liebergen ◽  
Annemieke Ansems ◽  
Laura Esteve Cuevas ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Emergency Department ◽  
Risk Stratification ◽  
Hospital Mortality ◽  
Systolic Blood Pressure ◽  
Older Patients ◽  
Tissue Perfusion ◽  
Case Mix ◽  
Suspected Infection ◽  
Resuscitation Guidelines

ObjectiveIn existing risk stratification and resuscitation guidelines for sepsis, a hypotension threshold of systolic blood pressure (SBP) below 90–100 mmHg is typically used. However, for older patients, the clinical relevance of a SBP in a seemingly ‘normal’ range (>100 mmHg) is still poorly understood, as they may need higher SBP for adequate tissue perfusion due to arterial stiffening. We therefore investigated the association between SBP and mortality in older emergency department (ED) patients hospitalised with a suspected infection.MethodsIn this observational multicentre study in the Netherlands, we interrogated an existing prospective database of consecutive ED patients hospitalised with a suspected infection between 2011 and 2016. We investigated the association between SBP categories (≤100, 101–120, 121–139, ≥140 mmHg) and in-hospital mortality in patients of 70 years and older. We adjusted for demographics, comorbidity, disease severity and admission to ward/intensive care using multivariable logistic regression.ResultsIn the 833 included older patients, unadjusted in-hospital mortality increased from 4.7% (n=359) in SBP ≥140 mmHg to 20.8% (n=96) in SBP ≤100 mmHg. SBP categories were linearly associated with case-mix-adjusted in-hospital mortality. The adjusted ORs (95% CI) for ≤100, 101–120 and 121–139 mmHgcompared with the reference of ≥140 mmHg were 3.8 (1.8 to 7.8), 2.8 (1.4 to 5.5) and 1.9 (0.9 to 3.7), respectively.ConclusionIn older ED patients hospitalised with a suspected infection, we found an inverse linear association between SBP and case-mix-adjusted in-hospital mortality. Our data suggest that the commonly used threshold for hypotension is not clinically meaningful for risk stratification of older ED patients with a suspected infection.

scholarly journals Revised trauma scoring system to predict in-hospital mortality in the emergency department: Glasgow Coma Scale, Age, and Systolic Blood Pressure score

Critical Care ◽  
2011 ◽  
Vol 15 (4) ◽  
pp. R191 ◽  
Author(s):  
Yutaka Kondo ◽  
Toshikazu Abe ◽  
Kiyotaka Kohshi ◽  
Yasuharu Tokuda ◽  
E Francis Cook ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Emergency Department ◽  
Glasgow Coma Scale ◽  
Hospital Mortality ◽  
Systolic Blood Pressure ◽  
Scoring System ◽  
Coma Scale ◽  
Trauma Scoring

EFEKTIVITAS PEMBERIAN HYDROTHERAPI RENDAM KAKI PADA PENDERITA HIPERTENSI DI BANJAR SRI MANDALA, KELURAHAN DAUHWARU KABUPATEN JEMBRANA

2019 ◽  
Vol 10 (01) ◽  
pp. 33-44
Author(s):  
N.L.G. Sudaryati ◽  
I P. Sudiartawan ◽  
Dwi Mertha Adnyana
Keyword(s):  
Blood Pressure ◽  
Systolic Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Pressure Measurement ◽  
Blood Pressure Measurement ◽  
Reduce Blood Pressure ◽  
Second Grade ◽  
Control Group ◽  
Hypertensive Patients ◽  
First Category

The aim of the study was to determine the effectiveness of giving hydrotherapi foot soak in hypertensive patients. The study was conducted with one group pretestposttest design without a control group by measuring blood pressure (pretest) before being given an intervention in the form of foot soak hydrotherm against 15 people with hypertension in Banjar Sri Mandala, Dauhwaru Village, Jembrana Subregency. Then do the blood pressure measurement again (posttest) after finishing the intervention. After the study was completed, the results showed that before the hydrotherapi foot bath intervention, there were 0% of patients classified as normal, 13.32% in prehypertension category, 60.08% in hypertension category I and 26.60% in hypertension category II. After the intervention was given, there were 13.32% of the patients classified as normal, 66.68% in the prehypertension category, 20.00% in the first category of hypertension and no patients belonging to the second grade hypertension category. There is a decrease of 20-30 mmHg for systolic blood pressure and 0-10 mmHg for diastolic blood pressure after intervention. Based on the results of the study it can be concluded that the hydrotherapi foot bath is effectively used to reduce blood pressure in hypertensive patients in the Banjar Sri Mandala, Dauhwaru Village, Jembrana District.

ASSESSING THE OUTCOMES OF TREATMENT AND MANAGEMENT, 400 HYPERTENSIVE PATIENTS IN BONG SON GENERAL HOSPITAL, BINH DINH PROVINCE

2016 ◽  
pp. 31-40
Author(s):  
Long Nhon Phan ◽  
Van Minh Huynh ◽  
Thi Kim Nhung Hoang ◽  
Van Nham Truong
Keyword(s):  
Blood Pressure ◽  
Risk Stratification ◽  
Hypertensive Patient ◽  
Systolic Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Blood Pressure Target ◽  
Average Risk ◽  
Hypertensive Patients ◽  
Average Systolic Blood Pressure ◽  
Complications Of Stroke

Objective: To evaluate the results of treatment achieved blood pressure goal (BP goal) and results of hypertensive patient management. Subjects and methods: A study of 400 hypertensive patient intervention, treatment and management after 2 year. To assess the results of BP target, monitor the use of medicines, the situation of hospitalization and complications of stroke. Results: Treatment: -100% of patients using diuretics and angiotensin-converting enzyme inhibitors (ACEIs), 33% of patients using angiotensin receptor blockers (ARBs), 46.25% of patients using calcium channel blockers (CCBs) and 19.5% of patients using beta-blocker. After 24 months of treatment: 50.5% of patients using 1 antihypertensive drug, 22% of patients using 2 drugs, 20.5% of patients using 3 drugs and 7% of patients taking more than 3 drugs. After 24 months of treatment: 91.75% achieved BP target and 8.25% fail. -Average risk stratification: 97.32% achieved BP target, hight risk stratification: 95.91% and very hight risk stratification: 73.03%. After 24 months of treatment. -Stage 1: 88.48% achieved BP target, stage 2: 92.85% achieved BP target and stage 3: 71.08% achieved BP target. After 24 months of treatment. -Hypertesive results before treatment were: 159.80 ± 20,22mmHg average systolic blood pressure and 82.97 ± 5,82mmHg average diastolic blood pressure. After treatment: average systolic blood pressure 125.38 ± 6,88mmHg and average diastolic blood pressure 79.83 ± 1,79mmHg. No adverse change in the index of tests about lipidemia, liver, kidney, glucomia and no recorded cases of drug side effects. Management of patients: -There were 89% non-medical examinational patients 1 month, 5.25% non-medical examinational patients 2 months, 4.25% non-medical examinational patients 3 months and 1.5% non-medical examinational patients 4 months. There were 93.5% drop pill 1 month, 3.25% drop pill 2 months, 4.25% drop pill 3 months and no patient drop pill over 3 months. In 24 months follow-up, 47% hospitalized inpatients <5 times, 44.5% hospitalized inpatients 5-10 times, 3% hospitalized inpatients 11-15 times, 4.75% hospitalized inpatients from 16-20 times and 0.75% hospitalized inpatients > 20 times. -There were 32.75% hospitalized inpatients for reasons of hypertension and 63.75% hospitalized inpatients for other common diseases. -There were a total of 11592 contacts directly by phone for medical advice, medical reminders and examinational reminders during 24 months of management. -There were 0.5% of patients stroked during 24 months of treatment and management. Conclusion: Treatment by protocol and management by phone directly for medical taking and re-examinational reminders is the best resulted method of achieving blood pressure target and reducing complications of stroke for hypertensive patients. Key word: : blood pressure target; risk stratification; treatment; management; stage; phone.

Bioinformatics Study on Serum Triglyceride Levels for Analysis of a Potential Risk Factor Affecting Blood Pressure Variability

2019 ◽  
Vol 14 (5) ◽  
pp. 376-385 ◽  
Author(s):  
Lin Xu ◽  
Jiangming Huang ◽  
Zhe Zhang ◽  
Jian Qiu ◽  
Yan Guo ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Systolic Blood Pressure ◽  
Blood Pressure Variability ◽  
Partial Correlation ◽  
Pearson Correlation ◽  
Target Organ Damage ◽  
Serum Triglyceride ◽  
Hypertensive Patients ◽  
Group A ◽  
Group B

Objective: The purpose of this study was to establish whether Triglycerides (TGs) are related to Blood Pressure (BP) variability and whether controlling TG levels leads to better BP variability management and prevents Cardiovascular Disease (CVD). Methods: In this study, we enrolled 106 hypertensive patients and 80 non-hypertensive patients. Pearson correlation and partial correlation analyses were used to define the relationships between TG levels and BP variability in all subjects. Patients with hypertension were divided into two subgroups according to TG level: Group A (TG<1.7 mmol/L) and Group B (TG>=1.7 mmol/L). The heterogeneity between the two subgroups was compared using t tests and covariance analysis. Results: TG levels and BP variability were significantly different between the hypertensive and non-hypertensive patients. Two-tailed Pearson correlation tests showed that TG levels are positively associated with many BP variability measures in all subjects. After reducing other confounding factors, the partial correlation analysis revealed that TG levels are still related to the Standard Deviation (SD), Coefficient of Variation (CV) of nighttime systolic blood pressure and CV of nighttime diastolic blood pressure, respectively (each p<0.05). In the subgroups, group A had a lower SD of nighttime Systolic Blood Pressure (SBP_night_SD; 11.39±3.80 and 13.39±4.16, p=0.011), CV of nighttime systolic blood pressure (SBP_night_CV; 0.09±0.03 and 0.11±0.03, p=0.014) and average real variability of nighttime systolic blood pressure (SBP_night_ARV; 10.99±3.98 and 12.6±3.95, p=0.024) compared with group B, even after adjusting for age and other lipid indicators. Conclusion: TG levels are significantly associated with BP variability and hypertriglyceridemia, which affects blood pressure variability before causing target organ damage.

Therapieziele bei der Hypertoniebehandlung

2017 ◽  
Vol 142 (19) ◽  
pp. 1420-1429 ◽  
Author(s):  
Rainer Düsing
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Risk ◽  
Systolic Blood Pressure ◽  
Measurement Procedure ◽  
Treatment Goals ◽  
High Cardiovascular Risk ◽  
Hypertensive Patients ◽  
Optimal Target ◽  
Elderly Hypertensive ◽  
Intervention Trials

AbstractThe optimal target blood pressure (BP) in the treatment of hypertensive patients remains controversial. Recently, the systolic blood pressure trial (SPRINT) has proposed that a target systolic blood pressure of < 120 mmHg provides prognostic benefit in elderly hypertensive patients at high cardiovascular risk. The results of SPRINT contrast with several other intervention trials which have investigated the effect of intense BP lowering (Secondary Prevention of Small Subcortical Strokes [SPS3], Action to Control Cardiovascular Risk in Diabetes [ACCORD], Heart Outcomes Prevention Evaluation [HOPE]-3). The differences in outcomes in SPRINT vs. other intervention trials are, to a large extend, due to an "unobserved" BP measurement procedure utilized in the SPRINT trial. Thus, a BP goal of < 120 mmHg, at least by conventional BP measurement, remains unproven. Independent of SPRINT the controversial evidence with respect to BP targets calls for further studies and, possibly, for more individualized treatment goals.

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