| Autor: |
Koracevic G; Department for Cardiovascular Diseases, University Clinical Center Nis, Serbia., Stojanovic M; Institute for Treatment and Rehabilitation Niska Banja, Nis, Serbia., Lovic D; Clinic for Internal Diseases Inter Medica, Nis, Serbia., Kostic T; Department for Cardiovascular Diseases, University Clinical Center Nis, Serbia., Tomasevic M; Faculty of Medicine and Department for Cardiovascular Diseases, University of Kragujevac and University Clinical Center of Serbia, Belgrade, Serbia., Martinovic SS; Department for Cardiovascular Diseases, University Clinical Center Nis, Serbia., Zdravkovic SC; Department for Cardiovascular Diseases, University Clinical Center Nis, Serbia., Koracevic M; Serbia Innovation Center, University of Nis, Serbia., Stojanovic V; Department for Cardiovascular Diseases, University Clinical Center Nis, Serbia. |
| Jazyk: |
angličtina |
| Zdroj: |
The National medical journal of India [Natl Med J India] 2023 Jul-Aug; Vol. 36 (4), pp. 257-262. |
| DOI: |
10.25259/NMJI_160_21 |
| Abstrakt: |
Background Hypertensive emergencies (HTN-E) are important due to a high risk of mortality. However, a sudden increase in blood pressure (BP) can damage target organs before the BP reaches cut-offs to diagnose HTN-E. We (i) analyse HTN guidelines for recommendations of treatment individualization, such as adjusting BP cut-offs for hypertensive urgency or impending HTN-E according to patient's susceptibility to complications (because of previous hypertension-mediated organ damage [HMOD], cardiovascular events and comorbid conditions), and (ii) provide a rationale for the inclusion of patient's susceptibility in protocols for treatment of acute HTN-E. Methods We searched PubMed, SCOPUS, Science Direct, Springer, Oxford Press, Wiley, SAGE and Google Scholar for the following terms: arterial hypertension, impending, emergency, target organ damage, hypertension-mediated organ damage, and comorbidity. Results The available guidelines do not recommend that when we estimate the probability of HTN-E in a patient with very high BP, we take into account not only the 'aggressive factor' (i.e. history of HTN, absolute BP values and rate of its increase), but also the 'vulnerability of the patient' due to previous major adverse cardio-vascular events, HMOD and comorbid conditions. Conclusion The risk does not depend only on the aggressiveness of the health threat but also on the strength of the host's defence. It is, therefore, surprising that one side of the natural interaction (i.e. susceptibility of a patient) is overlooked in almost all available guidelines on HTN. |
| Databáze: |
MEDLINE |
| Externí odkaz: |
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