• Christos Fragoulis, Dimitrios Polyzos, Andreas Mavroudis, Panagiotis-Anastasios Tsioufis, Alexandros Kasiakogias, Ioannis Leontsinis, Emmanouil Mantzouranis, Theodoros Kalos, Athanasios Sakalidis, John Ntalakouras, Ioannis Andrikou, Kyriakos Dimitriadis, Dimitris Konstantinidis, Costas Thomopoulos, and Konstantinos Tsioufis.
• First Department of Cardiology, National and Kapodistrian University of Athens, Hippokration Hospital, 114 Vassilissis Sofias Avenue, 11527 Athens, Greece.
• Eur. J. Intern. Med. 2024 Feb 1; 120: 107113107-113.

AbstractThere are scarce data on the comparative prognosis between patients with hypertensive emergencies (HE), urgencies (HU), and those without HU or HE (HP). Our study aimed to compare cardiovascular (CV) outcomes of HE, HU, and HP during a 12-month follow-up period. The population consisted of 353 consecutive patients presenting with HE or HU in a third-care emergency department and subsequently referred to our hypertension center for follow-up. After both groups completed scheduled follow-up visits, patients with HU were matched one-to-one by age, sex, and hypertension history with HP who attended our hypertension center during the same period. Primary outcomes were 1) a recurrent hypertensive HU or HE event and 2) non-fatal CV events (coronary heart disease, stroke, heart failure, or CV interventions), while secondary outcomes were 1) all-cause death, 2) CV death, 3) non-CV death, and 4) any-cause hospitalization. Events were prospectively registered for all three groups. During the study period, 81 patients were excluded for not completing follow-up. Among eligible patients(HE = 94; HU = 178), a total of 90 hospitalizations and 14 deaths were recorded; HE registered greater CV morbidity when compared with HU (29 vs. 9, HR 3.43, 95 % CI 1.7-6.9, p = 0.001), and increased CV mortality (8 vs. 1, HR 13.2, 95 % CI 1.57-110.8, p = 0.017). When opposing HU to HP, events did not differ substantially. Cox regression models were adjusted for age, sex, CV and chronic kidney disease, diabetes mellitus, and smoking. During 1-year follow-up, the prognosis of HU was better than HE but not different compared to HP. These results highlight the need for improved care of HU and HE.Copyright © 2023. Published by Elsevier B.V.

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