Management of hypertensive emergencies in the emergency department: presenting complaints and outcomes

Aims: This study aimed to evaluate the clinical features, management strategies, and outcomes of patients presenting with hypertensive conditions to the emergency department (ED). The findings aim to contribute to the epidemiological profiling of hypertensive emergencies and enhance management practices in EDs. Methods: A retrospective, observational study was conducted at Ankara Etlik City Hospital ED between September 16 and September 23, 2024. Patients aged ?18 years with a blood pressure (BP) ?140/90 mmHg were included. Pregnant, postpartum, or breastfeeding women and those with incomplete data were excluded. Data were collected on demographics, clinical features, comorbidities, diagnostics, treatments, and outcomes. Statistical analysis involved descriptive and comparative methods, with significance set at p<0.05. Results: The study included 111 patients (61 females, 55%; 50 males, 45%) with a mean age of 56.36 years. Among them, 10 patients (9.9%) required hospitalization, while 100 (90.1%) were discharged. The mean systolic and diastolic BP were 163.7 mmHg and 89.3 mmHg, respectively. Common presenting symptoms included headache (14.4%), chest pain (5.5%), and hematuria (1.8%), while 10.8% were asymptomatic. Hospitalization rates were significantly higher in female patients (p=0.012). However, no significant associations were found between BP values, diagnostic interventions, or treatments and hospitalization outcomes. Conclusion: The study highlights the challenges in managing hypertensive patients in EDs, especially those without target organ damage. While female patients showed higher hospitalization rates, factors like BP levels and diagnostic interventions did not correlate with outcomes. Further multicenter and prospective studies are needed to explore these findings and develop individualized, evidence-based approaches for hypertensive patient care in EDs.