Abstract
Original Research Article
Full Article (FREE DOWNLOAD)
SMJS Volume 5 Issue 1, Page 12- Page 24
MANAGEMENT AND OUTCOMES OF HYPERTENSIVE CRISES IN EMERGENCY SETTINGS: A COMPREHENSIVE SYSTEMATIC REVIEW
Seham S. Alshalahi, Ahmed H. Almutairi, Dhai Almuteri, Leena A. Alomar, Mariya Ezmirly, Dimah Alafaliq, Mohammed Alqahtani, Ayesha Aldhamer, Marwan Almokhalfi, Abdulrahman Almasoud,
Abdulmalik Zaheralliyali, Abdulaziz Aldaghmani, Abdullah A. Kh. Alenezi, Nasibah Alshanqiti
To cite this article: Alshalahi SS, Almutairi AH, Almuteri D, Alomar LA, Ezmirly M, Alafaliq D, Alqahtani M, Aldhamer A, Almokhalfi M, Almasoud A, Zaheralliyali A, Aldaghmani A, Alenezi AAK2, Alshanqiti
N. Management and Outcomes of Hypertensive Crises in Emergency Settings: A Comprehensive Systematic Review. Saudi Med J Students. 2024;5(1):12-24
Background
Hypertensive crises, encompassing both emergencies and urgencies, present with varied symptoms and can lead to significant morbidity and mortality if not managed appropriately. Despite the common use
of antihypertensive therapies, optimal management in ED remains a clinical challenge.
Aim: The aim of this study was to assess the effectiveness and outcomes of management strategies for hypertensive crises in emergency settings, guiding clinical practice and identifying gaps in current research
Methods
A comprehensive systematic review included studies from 1993 to 2023, totaling 27,808 adult patients with hypertensive crises. Adult patients aged 18 years and above with a hypertensive crisis treated in EDs were included. Pregnant women, individuals under 18, and non-ED settings were excluded. Management strategies encompassed IV antihypertensive agents for emergencies and oral medications for urgencies, focusing on CCBs, β blockers, and other antihypertensive classes. Primary outcomes were mortality, morbidity, and complications related to hypertensive crisis management. Secondary outcomes included patient discharge rates and education on red flag symptoms.
Results
Calcium channel blockers, especially Nicardipine, were predominant in managing hypertensive crises, with significant patient discharge rates post-intervention. Stroke was the most common complication, emphasizing the need for effective blood pressure control; 54.17% of patients were eventually discharged.
Conclusion
Nicardipine is effective in hypertensive crisis management in EDs. Stroke is a notable complication, underscoring the importance of timely intervention. Furthermore, findings support the use of CCBs in hypertensive crises and highlight the need for patient education on symptom monitoring post-discharge. Future research should focus on long-term outcomes, personalized medicine approaches, and randomized controlled trials for novel therapies.
