Hypertensive emergencies in diabetic patients from predominantly African American urban communities
| Autor: | Christine Makdisi, Shelly A Jones Dillon, Shreni N Zinzuwadia, Nkehci Mbadugha, Irina Benenson, Ela Aris, Frederick A Waldron, Adedamola M Adeboye, Natali Vicente |
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| Rok vydání: | 2018 |
| Předmět: |
Male
medicine.medical_specialty Urban Population Physiology Blood Pressure 030204 cardiovascular system & hematology Coronary artery disease 03 medical and health sciences 0302 clinical medicine Risk Factors Internal medicine Diabetes mellitus Hyperlipidemia Diabetes Mellitus Internal Medicine medicine Humans Hypertensive emergency 030212 general & internal medicine Myocardial infarction New Jersey business.industry Incidence Hypertensive urgency General Medicine Emergency department Middle Aged medicine.disease Black or African American Heart failure Hypertension Female Emergencies business |
| Zdroj: | Clinical and Experimental Hypertension. 41:531-537 |
| ISSN: | 1525-6006 1064-1963 |
| DOI: | 10.1080/10641963.2018.1516774 |
| Popis: | Aim: The aim of this study was to identify risk factors for hypertensive emergencies in diabetic patients presenting with severely elevated blood pressure. Methods: Using electronic medical records, this study identified diabetic patients with hypertensive crisis who presented to the emergency department of Newark Beth Israel Medical Center, Newark, NJ from June 2013 to May 2016. Diabetic patients with hypertensive emergencies were compared with non-diabetic patients based on important demographic and clinical characteristics. Results: Patients with diabetes accounted for 52.27% of all hypertensive emergencies during the study period. There were 264 diabetic patients with hypertensive emergencies and 519 diabetic patients with hypertensive urgencies. The majority of patients were African Americans (88.6%). The odds of hypertensive emergencies were strikingly higher in diabetic patients with hyperlipidemia (OR 1.66, 95% CI 1.23-2.24), coronary artery disease (OR 2.95, 95% CI 2.15-4.05), congestive heart failure (OR 6.28, 95% CI 4.49-8.80), renal insufficiency (OR 2.84, 95% CI 2.10-3.86) and low hemoglobin (OR 0.9, 95% CI 0.84-0.97). Acute or worsening heart failure was the most frequent acute target organ injury (49.6%) followed by non-ST elevation myocardial infarction (41.7%). Diabetic and non-diabetic patients had similar rates of target organ injuries. Conclusion: The development of hypertensive emergencies in patients with diabetes was not because of diabetes per se but because of coexisting highly elevated blood pressure. Tight blood pressure control may decrease the risk of hypertensive emergencies in this patient population. |
| Databáze: | OpenAIRE |
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