Risk of cardiovascular complications in patients with frequent hypertensive crises


Aim. To investigate a relative risk of cardiovascular complications in uncomplicated hypertensive crises (UHC) in hypertensive patients.
Material and methods. A questionnaire retrospective case-control study covered one-third of patients registered in the data base of a hospital or outpatient clinic. The patients were matched by basic characteristics. By frequency of UHC the patients were divided into two groups. Group 1 (n = 305) comprised patients with frequent (weekly or more often) UHC, group 2 (n = 558) consisted of patients with rare UHC (monthly or less frequent).
Results. Patients of group 1 had a longer history of arterial hypertension (13 ± 9 years vs 9 ± 7.8 years, p < 0.05). The target blood pressure was achieved in group 1 in 42% vs 56% in group 2; p < 0.05). Group 1 patients had a higher risk of non-fatal stroke/transient ischemic attack (TIA) - 18 and 10% (OR 1.94, 95% CI 1.28-2.93; p < 0.05), chronic cardiac failure (44 vs 30%; OR 1.64; 95% CI 1.22-2.21; p < 0.05), left ventricular hypertrophy (72 and 56%; OR 2.11; 95% CI 1.52-2.93; p < 0.05) and myocardial ischemia (56 and 38%; OR 2.05; 95%CI 1.53-2.74; p < 0.05). UHC frequency had no significant influence on the risk of non-fatal myocardial infarction (19 vs 15%; OR 1.34; 95% CI 0.92-1.94; p > 0.05).
Conclusion. Frequent UHC raise the risk of non-fatal acute disorder of cerebral circulation, chronic cardiac failure, ischemia and left ventricular hypertrophy. Frequency of UHC is not related to the risk of myocardial infarction.


  1. World Health Report 2002: Reducing risks, promoting healthy life. Geneva, Switzerland: World Health Organization. 2002. http://www.who.int/whr/2002/.
  2. The Seventh report of the Joint National Committee on Prevention, Detection. Evaluation, and Treatment of High Blood Pressure. J. A. M. A. 2003; 289:2560-2571.
  3. Shalnova S. A., Deev D. A., Oganov G. S., Zhukovsky G. S. Arterial hypertension impact on mortality in Russia. Eur. Heart J. 1998; 19: 705.
  4. Кобалава Ж. Д., Гудков К. М. Гипертонические кризы: существуют ли реальные противоречия в классификации и лечении? Сердце 2003; 2(3): 116-127.
  5. Задионченко В. С., Горбачева Е. В. Гипертонические кризы. Рус. мед. журн. 2001; 9: 628-630.
  6. Кобалава Ж. Д., Терещенко С. Н., Котовская Ю. В., Александрия Л. Г. Карведилол в лечении среднетяжелой эссенциальной гипертонии. Клин. фармакол. и тер. 1998; 3: 35-37.
  7. Галявич А. С. Диагностика и лечение артериальных гипертоний. Казань: ГУП «ПИК "Идеал-Пресс"», 2000.
  8. Varon J., Fromm R. E. Jr. Hypertensive crises. The need for urgent management. Postgrad. Med. 1996; 99(1): 189-200.
  9. Kitiyakara C., Guzman N. Malignant hypertension and hypertensive emergencies. J. Am. Soc. Nephrol. 1998; 9: 133-142.
  10. Zampaglione P., Pascale C. et al. Hypertensive urgencies and emergencies. Prevalence and clinical presentation. Hypertension 1996; 27: 144-147.
  11. Kincaid-Smith P., McMichael J., Murphy E. A. The clinical course and pathology of hypertension with papilloedema (malignant hypertension). Quart. J. Med. 1958; 37: 117-153.
  12. Beckgaard P., Kopp H., Neilson J. One thousand hypertensive patients followed from 16-22 years. Acta Med. Scand. 1956; suppl. 312: 175-183.
  13. Guidelines Committee. 2003 European Society of Hypertension-European Society of Cardiology guidelines for the management of arterial hypertension. J. Hypertens. 2003; 21: 1011-1053.
  14. Chobanian A. V., Bakris G. L., Black H. R. et al. The Seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC7 report. J. A. M. A. 2003; 289: 2560-2572.
  15. Mansoor A. F., Keefer H. The dangers of immediate-release nifedipine for hypertensive crises. Pharm. ther. 2002; 7: 362- 365.
  16. Karras D. J., Ufberg J. W., Heipern K. L. et al. Elevated blood pressure in urban emergency department patients. Acad. Emerg. Med. 2005; 12: 835-843.
  17. Hyman D. J., Pavlik V. N. Characteristics of patients with uncontrolled hypertension in the United States. N. Engl. J. Med. 2001; 345: 479-486.
  18. Tisdale J. E., Huang M. B., Borzak S. Risk factors for hypertensive crisis: importance of out-patient blood pressure control. Fam. Pract. 2004; 21: 420-424.
  19. Vlcek M., Bur A., Woisetschläger C. et al. Association between hypertensive urgencies and subsequent cardiovascular events in patients with hypertension. J. Hypertens. 2008; 26: 657-662.
  20. Verdecchia P., Reboldi G. P. Hypertension and microalbuminuria: the new detrimental duo. Blood Press. 2004; 13: 198-211.
  21. Koren M. J., Ulin R. J., Koren A. T. et al. Left ventricular mass change during treatment and outcome in patients with essential hypertension. Am. J. Hypertens. 2002; 15: 1021-1028.
  22. Lewington S., Clarke R., Qizilbash N. et al. Age-specific relevance of usual blood pressure to vascular mortality: A meta-analysis of individual data for one million adults in 61 prospective studies. Prospective Studies Collaboration. Lancet 2002; 360: 1903-1913.
  23. Perez M. I., Musini V. M. Pharmacological interventions for hypertensive emergencies. Cochrane Database Syst. Rev. 2008; 1: Art. CD003653.



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