CLINICAL CHARACTERISTICS, OFFICE BLOOD PRESSURE, AND HOME BLOOD PRESSURE OF PATIENTS DIAGNOSED WITH HYPERTENSION IN THE EMERGENCY DEPARTMENT

Year 2023, Volume: 30 Issue: 3, 454 - 464, 23.09.2023

Fuat Polat , Zeynettin Kaya , Mehmet Ali Özbek , İsmail Ateş

https://doi.org/10.17343/sdutfd.1336150

Abstract

Objective
This study aimed to investigate the characteristics of
patients presenting to the emergency department (ED)
with high blood pressure for the first time, comparing
their blood pressure measurements in the ED, office,
and home settings, and evaluating the diagnostic
value for hypertension.
Material and Method
A total of 109 patients with no previous history of
hypertension, presenting with various symptoms,
were included. Baseline characteristics and blood
pressure measurements in the ED, office, and home
were analyzed.
Results:
The study population (mean age: 48.5±12.9 years,
44% male) had a mean systolic blood pressure (SBP)
of 166.87 (±16.24) mmHg and mean diastolic blood
pressure (DBP) of 94.95 (±11.98) mmHg in the ED.
SBP and DBP measured in the ED were significantly
higher than office and home measurements
(p<0.001). According to both office and home blood
pressure measurements, 56.9% of the patients were
hypertensive (SBP ≥140 and/or DBP ≥90 mmHg)
Significant correlations were found between SBP
and grade 1 or higher hypertensive retinopathy
(p=0.002), hypothyroidism (p=0.007), low hemoglobin
levels (p=0.026), high potassium levels (p=0.05), and
relative wall thickness (p=0.05). DBP was significantly
correlated with male gender (p=0.05), grade 1 or
higher hypertensive retinopathy (p=0.025), obesity
(p=0.037), and low hemoglobin levels (p=0.047).
Conclusion
Patients with initial high blood pressure in the ED
had lower blood pressure readings in the office and
at home. However, over half of these patients were
diagnosed with hypertension during follow-up. These
findings highlight the importance of considering the
setting of blood pressure measurements and the
need for follow-up evaluations to accurately diagnose
hypertension in ED patients presenting with high
blood pressure.

Keywords

Emergency department blood pressure, office blood pressure, home blood pressure

ACİL SERVİSTE HİPERTANSİYON TANISI ALAN HASTALARIN KLİNİK ÖZELLİKLERİ, OFİS TANSİYONLARI VE EV TANSİYONLARI

Abstract

Amaç
Bu çalışmanın amacı, acil servise ilk kez yüksek tansiyon
ile başvuran hastaların özelliklerini araştırmak,
acil servis, ofis ve ev ortamlarındaki kan basınç ölçümlerini
karşılaştırmak ve hipertansiyon için tanısal
değerini değerlendirmektir.
Gereç ve Yöntem
Daha önce hipertansiyon öyküsü olmayan, çeşitli
semptomlarla başvuran toplam 109 hasta dahil edildi.
Acil serviste, ofiste ve evde temel özellikler ve kan basıncı
ölçümleri analiz edildi.
Bulgular
Çalışma popülasyonunun (ortalama yaş: 48,5±12,9
yıl, %44 erkek) acil serviste ortalama sistolik kan
basıncı (SKB) 166,87 (±16,24) mmHg ve ortalama
diyastolik kan basıncı (DKB) 94,95 (±11,98) mmHg
idi. Acil serviste ölçülen SKB ve DKB, ofis ve ev ölçümlerinden
anlamlı olarak yüksekti (p<0.001). Hem
ofis hem de ev kan basıncı ölçümlerine göre hastaların
%56,9'u hipertansif (SKB ≥140 ve/veya DBP ≥90
mmHg) idi. SKB ile grade 1 ve üzeri hipertansif retinopati
(p=0,002), hipotiroidizm (p=0,007), düşük hemoglobin
düzeyi (p=0,026), yüksek potasyum düzeyi
(p=0,05) ve göreceli duvar kalınlığı ( p=0.05). DKB,
erkek cinsiyet (p=0,05), grade 1 ve üstü hipertansif
retinopati (p=0,025), obezite (p=0,037) ve düşük
hemoglobin düzeyi (p=0,047) ile anlamlı korelasyon
gösterdi.
Sonuç
Acil serviste başlangıçta yüksek tansiyonu olan hastalarda,
ofiste ve evde daha düşük tansiyon değerleri
vardı. Ancak bu hastaların yarısından fazlasına takip
sırasında hipertansiyon tanısı konmuştur. Bu bulgular,
yüksek tansiyon ile başvuran acil servis hastalarında
hipertansiyonu doğru bir şekilde teşhis etmek için kan
basıncı ölçümlerinin ayarlanmasının ve takip değerlendirmelerinin
dikkate alınmasının önemini vurgulamaktadır.

Keywords

Acil servis kan basıncı, ofis kan basıncı, ev kan basıncı

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