Profile of elderly hypertensive in the emergency room. A single emergency centre experience

Introduction: Hypertension (HTN) prevalence incre-ases with age and represents a common problem in the elderly (ELD). It represents a management dilemma with BP control rates lower in this group of patients.

Objective: To describe the profile of the ELD patient presenting with elevated BP at the emergency depart-ment (ED) of a tertiary care emergency hospital.

Methods: We retrospectively analysed all the charts of patients presenting at the ED of a tertiary care emer-gency hospital during 1 month (March 2018). We re-trieved demographic, clinical and treatment approach data from the ED charts of patients presenting for HTN defined as BP =>140/90 mm Hg. We compared different characteristics between ELD patients (above 75 years old) and younger patients (under 75 years old) (YNG). We defined a HTN emergency (EMG) as BP ≥180/120 mm Hg with acute HTN-mediated organ da-mage (HMOD) and a HTN urgency as BP ≥180/120 without acute HMOD (URG). In all other cases BP ≥140/90 mmHg was referred to as elevated BP (EBP).

Results: 293 patients (4.96% from all presentations) were evaluated for HTN, 54.9% women, mean age 62.9 5 years, with 66 (22.5%) ELD. The ELD, when compared with the YNG, were more frequently women (ELD vs. YNG, 71.2 vs. 50.2, p=0.00), with a previously known diagnosis of HTN (ELD vs. YNG, 87.9 vs. 64.3, p<0.001), a higher mean number of antihypertensive drugs at home (ELD vs. YNG, 1.64 ± 1.27 vs. 1.14 ± 1.28, p=0.00) and had more comorbidities including atrial fibrillation. ELD presented more frequently as EMG compared to the YNG (ELD vs. YNG, 21.1 vs. 9.6, p=0.01). The systolic BP at presentation was higher in ELD with the same mean diastolic BP. Diuretic the-rapy was the preferred lowering BP drug in the ELD.

Conclusions: The elderly represent an important pro-portion from the patients presenting for HTN at ED. They are more frequently women, have a higher burden of comorbidities. Diuretic therapy remains the prefer-red antihypertensive drug in the emergency settings. The ELD are becoming an important patient prototype with increasing life expectancy, and the number of pa-tients with HTN crises presenting in the ED is expected to rise if more aggressive antihypertensive drug therapy is not considered in these older patients.

ISSN – online: 2734 – 6382
ISSN-L 1220-658X
ISSN – print: 1220-658X
The Romanian Journal of Cardiology is indexed by:
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CODE: 379
CME Credits: 10 (Romanian College of Physicians)