https://orcid.org/0000-0001-6960-2825
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ABSTRACT
Hypertensive crisis is a common clinical situation that presents a high rate of morbidity and mortality and it is characterized by symptomatic rise of blood pressure (BP), systolic (SBP) ≥ 180 mmHg and/or diastolic (DBP) ≥ 120 mmHg. It is classified as emergency (HE) or hypertensive urgency (HU). There is no description of laboratory findings in patients who present acute BP elevation. Thus, this study had the objective to assess the biochemical-metabolic parameters of patients with HC. We studied 74 normotensive individuals (NT), 74 controlled hypertensive patients (ContrHT), 50 subjects with HU, and 78 with HE for evaluating biochemical-metabolic parameters. HE occurs in older individuals and more frequently in those with known hypertension. More patients with HE had dyslipidemia than those with HU (58% vs. 38%). The diastolic BP and heart rate were higher in the HE group (120 mmHg and 87 bpm) compared to ContrHT (71 mmHg and 71 bpm; p < 0.0001) and NT groups (75 mmHg and 68 bpm; p < 0.0001). Glycemia was higher in HE vs. NT and ContrHT (p < 0.05). HDL cholesterol was lower in HE than NT (p = 0.0088). Potassium was lower in HE vs. NT, ContrHT and HU groups (p < 0.05). Creatinine was higher in the HC group vs. NT and ContrHT (p < 0.05). The GFR was significantly lower in HE group vs. HU, ContrHT and NT (p < 0.001). In conclusion, individuals with HC show biochemical alterations when compared to ContrHT and NT. Acute BP elevations are associated with hyperglycemia, dyslipidemia, and higher potassium and creatinine levels and lower renal function.
Abbreviations
| BMI = | = | body mass index |
| BP = | = | blood pressure |
| CH = | = | hypertensive crisis |
| ContrHT = | = | controlled hypertensive |
| DBP = | = | diastolic blood pressure |
| GFR = | = | glomerular filtration rate |
| HbA1c = | = | glycated hemoglobin |
| HDLc = | = | high-density lipoprotein cholesterol |
| HE = | = | hypertensive emergency |
| HPLC = | = | high-performance liquid chromatography |
| HR = | = | heart rate |
| HU = | = | hypertensive urgency |
| JNC 7 = | = | VII Joint National Committee on the Detection, Evaluation, and Treatment of High Blood Pressure |
| LDLc = | = | low-density lipoprotein cholesterol |
| MDRD = | = | Modification of Diet in Renal Disease |
| NT = | = | normotensive |
| RASB = | = | renin-angiotensin system blockers |
| SBP = | = | systolic blood pressure |
| TC = | = | total cholesterol |
| TG = | = | triglycerides |
Acknowledgments
The authors thank the reviewer for correcting both spelling and grammar of the English text.
JFV-M did study design.
DOA, SPOS, MASP, MLG, FMV, MCG, DRSS, MFG, and JFV-M contributed equally to the literature search, data interpretation, figure creation, and writing of the manuscript. They have read and approved the final manuscript.
Funding
The authors thank FAPESP for the grant support (2013/09868-3).
Declaration of interest
The authors declare no conflict of interest.