Effects of acute blood pressure elevation on biochemical-metabolic parameters in individuals with hypertensive crisis

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). Th...

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Published in:	Clinical and experimental hypertension (1993) Vol. 39; no. 6; pp. 553 - 561
Main Authors:	Andrade, Days Oliveira, Santos, Sara Patrícia O, Pinhel, Marcela Augusta S, Valente, Flávia Mariana, Giannini, Marcela Cavichiolo, Gregório, Michele Lima, De Godoy, Moacir Fernandes, Souza, Dorotéia Rossi S, Vilela-Martin, José Fernando
Format:	Journal Article
Language:	English
Published:	England Taylor & Francis 18-08-2017 Taylor & Francis Group
Subjects:	Adult Age Factors Aged Aged, 80 and over Biochemistry Blood Pressure Body Mass Index Cholesterol, HDL - blood Cholesterol, LDL - blood Comorbidity Creatinine - blood Dyslipidemias - blood Dyslipidemias - epidemiology Female Glomerular Filtration Rate Heart Rate Humans Hyperglycemia - blood Hyperglycemia - epidemiology Hypertension - blood Hypertension - epidemiology Hypertension - physiopathology hypertensive crisis hypertensive emergency hypertensive urgency Male metabolic changes Middle Aged Potassium - blood metabolic changes Biochemistry hypertensive emergency hypertensive crisis hypertensive urgency
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Summary:	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
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	1064-1963 1525-6006
DOI:	10.1080/10641963.2017.1291661