P150 HYPERTENSION URGENCY: GUIDELINES INDICATIONS AND IMPLEMENTATION IN CLINICAL PRACTICE

Background and objective: Unreasonable admissions to hospital increase costs of the health care system. The maximum transfer of medical care to outpatient setting is a trend in modern medicine. Hypertension urgency (HU) is not accompanied by acute hypertension-mediated target organ damage and is not an indication for hospitalization of the patient. In 2018-2020 ISH/ESH Guidelines have revised the term “HU” for “uncontrolled hypertension”, approaches to its diagnosis and treatment. The purpose of the study is to evaluate the implementation of the Guidelines in real clinical practice. Methods: A single-center retrospective study was conducted in a private family medicine clinic, which has been observing a large number of patients of different age and gender for more than 30 years. The clinic has an emergency department, a hospital with 60 beds. Medical records of consecutive patients aged ≥18 years admitted to hospital in 2018 and 2023 with systolic blood pressure at admission ≥180 mmHg and/or diastolic blood pressure ≥110 mmHg were collected and analyzed. Results: The prevalence of patients admitted according to the chosen criteria was 0.8% (n=25) in 2018 and 0.9% (n=26) in 2023. According to the clinical characteristics and signs of acute damage to target organs (acute coronary syndrome, acute stroke, pulmonary embolism), 4% and 7.7% of cases in 2018 and 2023, respectively, were considered as hypertension emergencies. HU was diagnosed in other cases — 96% and 92.3%. HU was the direct cause of admission in 23.1% of cases in 2018 and in 28% of cases in 2023, in other cases - 69.2% (2018) and 64% (2023) hospitalization was due to another disease (pneumonia, neurological diseases, etc.). The probable causes of HU were patient non-compliance with antihypertensive drug therapy- 50% (2018) and 57% (2023), resistant hypertension, stress. Conclusions: The prevalence of patients admitted due to HU has not significantly changed. The most probable cause of HU is non-compliance with antihypertensive treatment, self-termination of treatment.