Characteristics and Prognosis of Patients With Hypertensive Encephalopathy: A French Nationwide Cohort Study.

Autor:	Halimi JM; Néphrologie-Immunologie Clinique, Hôpital Bretonneau, CHU Tours, France (J.-M.H., J.-P.d.F., P.G., B.S., V.M.).; EA4245, Transplantation Immunologie Inflammation (J.-M.H., P.G., D.A.), Université de Tours, France.; INI-CRCT, France (J.-M.H., B.S.)., de Fréminville JB; Néphrologie-Immunologie Clinique, Hôpital Bretonneau, CHU Tours, France (J.-M.H., J.-P.d.F., P.G., B.S., V.M.)., Gatault P; Néphrologie-Immunologie Clinique, Hôpital Bretonneau, CHU Tours, France (J.-M.H., J.-P.d.F., P.G., B.S., V.M.).; EA4245, Transplantation Immunologie Inflammation (J.-M.H., P.G., D.A.), Université de Tours, France., Bisson A; Service de Cardiologie, Centre Hospitalier Universitaire Trousseau et Faculté de Médecine, EA4245 (A.B., P.V., D.A., L.F.), Université de Tours, France., Sautenet B; Néphrologie-Immunologie Clinique, Hôpital Bretonneau, CHU Tours, France (J.-M.H., J.-P.d.F., P.G., B.S., V.M.).; INI-CRCT, France (J.-M.H., B.S.).; INSERM U1246 SPHERE, Université de Tours-Université de Nantes, France (B.S.)., Maisons V; Néphrologie-Immunologie Clinique, Hôpital Bretonneau, CHU Tours, France (J.-M.H., J.-P.d.F., P.G., B.S., V.M.)., Vigny P; Service de Cardiologie, Centre Hospitalier Universitaire Trousseau et Faculté de Médecine, EA4245 (A.B., P.V., D.A., L.F.), Université de Tours, France.; Service d'Information Médicale, d'Épidémiologie et d'Économie de la Santé, Centre Hospitalier Universitaire et Faculté de Médecine, EA7505 (P.V.), Université de Tours, France., Angoulvant D; EA4245, Transplantation Immunologie Inflammation (J.-M.H., P.G., D.A.), Université de Tours, France.; Service de Cardiologie, Centre Hospitalier Universitaire Trousseau et Faculté de Médecine, EA4245 (A.B., P.V., D.A., L.F.), Université de Tours, France., Fauchier L; Service de Cardiologie, Centre Hospitalier Universitaire Trousseau et Faculté de Médecine, EA4245 (A.B., P.V., D.A., L.F.), Université de Tours, France.
Jazyk:	angličtina
Zdroj:	Hypertension (Dallas, Tex. : 1979) [Hypertension] 2023 Aug; Vol. 80 (8), pp. 1716-1727. Date of Electronic Publication: 2023 Jun 07.
DOI:	10.1161/HYPERTENSIONAHA.123.21226
Abstrakt:	Background: Hypertensive encephalopathy (HE) constitutes a serious condition, usually observed in patients with long-lasting hypertension. Hypertension-associated HE is sometimes differentiated from the stroke-associated hypertensive emergency. Whether prognosis of hypertension-associated and stroke-associated HE is different is unclear. Methods: Characteristics and prognosis of HE were assessed in this nationwide retrospective cohort study in all patients with an administrative code of HE compared with age-, sex- and year of inclusion-matched controls admitted to French hospitals during the 2014 to 2022 period. Results: HE was identified in 7769 patients. Chronic kidney disease (19.3%), coronary artery disease (13.8%), diabetes (22.1%), and ischemic stroke (5.2%) were frequent but thrombotic microangiopathy, hemolytic-uremic syndrome, systemic sclerosis or renal infarction were <1%. HE prognosis was poor (death: 10.4%/y, heart failure: 8.6%/y, end-stage kidney disease: 9.0%/y, ischemic stroke: 3.6%/y, hemorrhagic stroke: 1.6%/y, dementia: 4.1%/y). The risk of death was increased to a similar extent in patients with HE, regardless of the presence of known hypertension or concomitant stroke (versus patients without HE). Among patients with HE, known hypertension was significantly associated with increased risks of ischemic stroke, hemorrhagic stroke, heart failure, vascular dementia, and all-cause dementia and to a lesser extent with chronic dialysis in multivariable analyses including adjustment on concomitant stroke. Conclusions: HE remains a considerable health burden and is associated with a poor prognosis. The distinction between hypertension- versus stroke-associated HE is relevant as these 2 situations convey different risks of stroke, heart failure, vascular dementia, and end-stage kidney disease. Competing Interests: Disclosures The authors report no conflicts of interest relating directly to the contents of this article. D. Angoulvant has received fees for lectures or consulting from Amgen, Alnylam, Sanofi, Novartis, AstraZeneca, Bayer, Bristol-Myers Squibb, Boehringer-Ingelheim France, MSD, Pfizer, Servier, and Vifor. J.M. Halimi has received fees for lectures or consulting from Alexion, AstraZeneca, Bayer, Boehringer-Ingelheim France, MSD, Sanofi, Servier, and Vifor. The other authors report no conflicts.
Databáze:	MEDLINE
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