Background: Current guidelines poorly define hypertensive urgency and recommend Oral (PO) medications over intravenous (IV).
Objective: To describe hospital management of hypertensive urgency and compare characteristics and outcomes of PO vs. IV medications.
Methods: We used descriptive statistics and created generalized linear models to evaluate within-subject blood pressure (BP) changes over 24 hours.
Results: 179 patients had an average age of 62 and 58% female. Chronic hypertension was common (165, 88%), as was chronic renal disease (40.6%). IV medications were common (146, 81.6%) and associated with higher comorbidity burden, prior kidney disease, and longer length of stay (2.5, 1.6-3.8 vs. 1.4, 0.9-2.2, p=0.007). 66 (35.3%) developed and 43 (23.5%) new organ dysfunction, but outcomes were similar between groups. BP was similar between groups after 12 hours.
Conclusions: IV medication use was common and decreased BP more rapidly. Outcomes including BP were similar to PO administration, except for length of stay.
Keywords: Hypertension; Hypertensive crisis; Hypertensive urgency.
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