Haemodynamic changes in emergency department patients with poorly controlled hypertension
| Autor: | Colin A. Graham, Mandy M. Tse, Cangel Pui-yee Chan, Marcus C K Tai, Timothy H. Rainer, Stewart Siu-Wa Chan |
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| Rok vydání: | 2016 |
| Předmět: |
Male
medicine.medical_specialty Cardiac output Cross-sectional study Cardiac index Hemodynamics Blood Pressure 030204 cardiovascular system & hematology 03 medical and health sciences 0302 clinical medicine Internal medicine medicine Humans 030212 general & internal medicine Cardiac Output Intensive care medicine Antihypertensive Agents Aged Aged 80 and over business.industry Ultrasonography Doppler General Medicine Emergency department Middle Aged Confidence interval Cross-Sectional Studies medicine.anatomical_structure Blood pressure Hypertension Vascular resistance Cardiology Hong Kong Female Vascular Resistance Emergency Service Hospital business |
| Zdroj: | Hong Kong Medical Journal. |
| ISSN: | 1024-2708 |
| DOI: | 10.12809/hkmj154566 |
| Popis: | Objectives: This study aimed to measure cardiac output, systemic vascular resistance, cardiac index, and systemic vascular resistance index in emergency department patients with poorly controlled hypertension; and to determine the frequency in which antihypertensive drugs prescribed do not address the predominant haemodynamic abnormality. Methods: This cross-sectional observational study was conducted in an emergency department of a 1400-bed tertiary hospital in Hong Kong. Patients aged 18 years or above, with systolic blood pressure of ≥160 mm Hg or diastolic blood pressure of ≥100 mm Hg based on two or more measurements and on two separate occasions within 2 to 14 days, were included. Haemodynamic measurements were obtained using a non-invasive Doppler ultrasound monitor. Doctors were blinded to the haemodynamic data. Any antihypertensive medication adjustment was evaluated for correlation with haemodynamic changes. Results: Overall, 164 patients were included. Their mean age was 69.0 years and 97 (59.1%) were females. Systemic vascular resistance and cardiac output were elevated in 65.8% (95% confidence interval, 57.9-72.9%) and 15.8% (10.8-22.5%) of patients, respectively. Systemic vascular resistance index and cardiac index were elevated in 43.9% (95% confidence interval, 36.2-51.8%) and 19.5% (13.9-26.5%) of patients, respectively. Of 71 patients in whom antihypertensive medications were adjusted, 25 (35.2%; 95% confidence interval, 24.5-47.5%) were prescribed agents that did not correlate with the primary haemodynamic abnormality. Conclusions: The profile of haemodynamic changes in emergency department patients with poorly controlled hypertension is characterised. The antihypertensive drugs prescribed did not correspond to the patient’s primary haemodynamic derangement in 35% of cases. |
| Databáze: | OpenAIRE |
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