The following is an overview of “Prevalence of Neurological Complaints in Emergency Department Patients with Severe Hypertension” published in the December 2022 issue. emergency medicine by Liebermann et al.
Neurologic symptoms can accompany severe hypertension, even without obvious target organ damage. However, significant hypertension can both induce and result in acute cerebrovascular episodes. In one study, researchers sought to ascertain the frequency and clinical characteristics of individuals with severe hypertension and neurological symptoms. Therefore, they used US population-level data.
They used nationally representative data from the National Hospital Ambulatory Care Survey (NHAMCS) collected from 2016 to 2019, defined as systolic blood pressure ≥180 mmHg and/or diastolic blood pressure ≥120 mmHg. identified an extremely hypertensive (BP) adult ED patient. In addition, the visit data field ED reason was used to define neurological symptoms, and the diagnostic data field was used to define acute target organ injury. To obtain national figures, they applied weights based on survey visits.
Based on 5,083 data from 2016 to 2019, 6.1% (95% CI: 5.7-6.5%) of all ED visits were in patients with severe hypertension, i.e. 40.4 million patients (95% CI: 37.5-43 million). Only 2.8% (95% CI: 2.0-3.9%) of severely hypertensive ED patients had acute cerebrovascular disease and 92.0% (95% CI: 90.3-93.4%) had hypertensive urgency. rice field. Both patients with (75.6%) and without (19.9%) cerebrovascular diagnosis reported frequent neurological problems. Compared with those without these symptoms, patients with hypertensive urgency with neurological problems were often older, female, and had a history of stroke or TIA. Dizziness and non-migraine headache were the two most common neurological symptoms.
One in 16 ED patients in a nationally representative sample had significantly elevated blood pressure, and one fifth of those patients reported neurological problems.