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    Practice patterns, outcomes, and end-organ dysfunction for patients with acute severe hypertension: the Studying the Treatment of Acute hyperTension (STAT) registry

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    Authors
    Katz, Jason N.
    Gore, Joel M.
    Amin, Alpesh
    Anderson, Frederick A. Jr.
    Dasta, Joseph F.
    Ferguson, James J.
    Kleinschmidt, Kurt
    Mayer, Stephan A.
    Multz, Alan S.
    Peacock, W. Frank
    Peterson, Eric D.
    Pollack, Charles V. Jr.
    Sung, Gene Yong
    shorr, Andrew
    Varon, Joseph
    Wyman, Allison
    Emery, Leigh A.
    Granger, Christopher B.
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    UMass Chan Affiliations
    Department of Medicine, Division of Cardiovascular Medicine
    Center for Outcomes Research
    Document Type
    Journal Article
    Publication Date
    2009-10-29
    Keywords
    Acute Disease
    Aged
    Antihypertensive Agents
    Blood Pressure
    Cross-Sectional Studies
    Female
    Follow-Up Studies
    Hospital Mortality
    Hospitalization
    Humans
    Hypertension
    Injections, Intravenous
    Male
    Middle Aged
    Outcome Assessment (Health Care)
    *Physician's Practice Patterns
    *Registries
    Retrospective Studies
    Severity of Illness Index
    United States
    Cardiovascular Diseases
    Health Services Research
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    Link to Full Text
    http://dx.doi.org/10.1016/j.ahj.2009.07.020
    Abstract
    BACKGROUND: Limited data are available on the care of patients with acute severe hypertension requiring hospitalization. We characterized contemporary practice patterns and outcomes for this population. METHODS: STAT is a 25-institution, US registry of consecutive patients with acute severe hypertension (>180 mm Hg systolic and/or >110 mm Hg diastolic; >140 and/or >90 for subarachnoid hemorrhage) treated with intravenous therapy in a critical care setting. RESULTS: One thousand five hundred eighty-eight patients were enrolled (January 2007 to April 2008). Median age was 58 years (interquartile range 49-70 years), 779 (49%) were women, and 892 (56%) were African American; 27% (n = 425) had a prior admission for acute hypertension and 486 (31%) had chronic kidney disease. Median qualifying blood pressure (BP) was 200 (186, 220) systolic and 110 (93, 123) mm Hg diastolic. Initial intravenous antihypertensive therapies used to control BP varied, with 1,009 (64%) patients requiring multiple drugs. Median time to achieve a systolic BP(hemorrhage) was 4.0 (0.8, 12) hours; 893 (60%) had reelevation to >180 (>140 for subarachnoid hemorrhage) after initial control; and 63 (4.0%) developed iatrogenic hypotension. Hospital mortality was 6.9% (n = 109) with an aggregate 90-day mortality rate of 11% (174/1,588); 59% (n = 943) had acute/worsening end-organ dysfunction during hospitalization. The 90-day readmission rate was 37% (523/1,415), of which one quarter (132/523) was due to recurrent acute severe hypertension. CONCLUSION: This study highlights heterogeneity in care, BP control, and outcomes of patients hospitalized with acute severe hypertension.
    Source
    Am Heart J. 2009 Oct;158(4):599-606.e1. Link to article on publisher's site
    DOI
    10.1016/j.ahj.2009.07.020
    Permanent Link to this Item
    http://hdl.handle.net/20.500.14038/27312
    PubMed ID
    19781420
    Related Resources
    Link to Article in PubMed
    ae974a485f413a2113503eed53cd6c53
    10.1016/j.ahj.2009.07.020
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