Medication, nocturnal dipping profile and hypertensive emergency

Resumen

Methods: A total of 233 patients (108 male, 125 female), 184 had hypertensive urgency/ 53 emergency (54.44% /50.95% in women) at the Emergency department during 11 months. Patients were divided in five age groups as decades starting from the age of 40 (mean 65.85 years) and a total ten groups depending on which type of hypertensive medication they were using (ACEi, ARB, BB, CCB, diuretics, moxonidine, and their combinations). Results: By using antihypertensive monotherapy percentage of hypertensive emergencies were 100.00%, 50.00%, 41.66%, 33.33%, 21.05%. Using ACEi + CCB + diuretic significantly decreased the number of emergencies to 0%, 18.47%, 21.05%, 25.00%, 33.33%; but adding beta blocker additionally diminished the risk. Overall 53 patients had no medication (22.75%) and 68 of 233 patients were smokers (29.18%, 63.23% male) of which 36 patients had hypertensive emergency (52.94% of smokers). The biggest number of non-dippers was found in patients who took ARBs, diuretics and/or CCB but the smallest number was shown in patients who took ACEi in combination with moxonidine (-20.07%). 22.02% of smokers were non-dippers (-54.67% nonsmokers). Odds ratio for getting hypertensive emergency in case patient had a non-dipper profile was 4.18 (CI 1.02 – 18.89, p < 0.05). Patients taking different medication (or none) did not have increased chance for hypertensive emergency development (OR 1.21, p = NS).