Hypertension Management in Terms of Routine Agents

October 8, 2024 updated by: Saglik Bilimleri Universitesi

Emergency Department Hypertension Management: Effects of Routine Oral Antihypertensive Agents on Emergency Management of Hypertension

known hypertensive patients admitted to emergency department with increased blood pressure will be evaluated in terms of antihypertensive agents given at hospital, degree of blood pressure decrease, hospital stay and laboratory and imaging tests ordered. The impact of routine oral antihypertensive agents used by the patients on these parameter will be assessed.

Study Overview

Status

Not yet recruiting

Conditions

Detailed Description

Hypertensive patients account for approximately 1-25% of annual emergency department visits . While this figure varies by region, hypertensive patients are among the groups that contribute significantly to emergency department crowding and workload . Hypertensive emergencies constitute about 0.3-0.9% of all patients, and this number is rapidly increasing each year .

The 2017 AHA hypertension guidelines emphasize that severe elevations in blood pressure (hypertensive crisis and hypertensive urgency) do not require emergency department visits or referrals unless there is end-organ damage . It is noted that treatment in these patients typically involves dose adjustment or a change in medication .

The 2023 ESC hypertension guidelines recommend that in patients presenting to the emergency department with a hypertensive crisis, blood pressure should be gradually lowered with oral agents over a 24-48 hour period. These patients do not usually require hospital admission but can be monitored in an outpatient setting for clinical evaluation. It is noted that their blood pressure may remain elevated upon discharge from the emergency department, and follow-up in a clinic is necessary for reevaluation of chronic therapy .

Some studies have indicated that both oral and intravenous treatments are preferred for patients presenting with hypertensive crises, highlighting that the approach can vary from physician to physician .

When evaluating literature reviews, published guidelines, and conducted studies, it is observed that there are differences between European and American approaches in defining and treating hypertensive crisis, as well as variability in physician management of these patients .

In our study, we plan to evaluate the effect of emergency department treatment on lowering blood pressure in known hypertensive patients (≥140/80) without end-organ damage. Additionally, we aim to assess the impact of the antihypertensive agents that patients routinely use on their length of stay in the emergency department, as well as the frequency and effectiveness of the medications used, and the target blood pressure values achieved post-treatment according to guidelines.

Study Type

Observational

Enrollment (Estimated)

350

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact Backup

Study Locations

  • Turkey
      • Ankara, Turkey, 06170
        • Etlik City Hospital
        • Contact:
        • Contact:
        • Contact:
          • Elif HAMZACEBIOGLU KAYISOGLU, Specialist
        • Contact:
          • Gulsen AKCAY, ass.prof.
        • Contact:
          • Ilker SIRIN, Specialist
        • Contact:
          • Fatma BUYUKCELEN CIFTCI, Resident
        • Contact:
          • Fatma Nur KOC, Resident
        • Contact:
          • Bedriye Muge SONMEZ, ass. prof.
      • Ankara, Turkey, 06790
        • Etimesgut Military Hospital
        • Contact:

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Sampling Method

Probability Sample

Study Population

patients with known hypertension admitted to emergency department with elevated blood pressure

Description

Inclusion Criteria:

  1. Patients aged 18 and older.
  2. Blood pressure measured at ≥140/80.
  3. Diagnosis of essential hypertension.

Exclusion Criteria:

  1. Pregnant patients.
  2. Individuals without a prior diagnosis of hypertension.
  3. Patients with end-organ damage (hypertensive emergency).
  4. Patients whose routine antihypertensive agents are unavailable.
  5. Patients who leave the clinic without permission, making follow-up data inaccessible.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

Cohorts and Interventions

Group / Cohort
diuretics
patients prescribed diuretics for oral treatment admitted to emergency service with elevated blood pressure
Beta Blockers
patients prescribed Beta Blockers for oral treatment admitted to emergency service with elevated blood pressure
Calcium Channel Blockers
patients prescribed Calcium Channel Blockers for oral treatment admitted to emergency service with elevated blood pressure
ACE (angiotensin converting enzyme) Inhibitors
patients prescribed ACE (angiotensin converting enzyme) Inhibitors for oral treatment admitted to emergency service with elevated blood pressure
ARB( angiotensin receptor blockers)
patients prescribed ARB( angiotensin receptor blockers) for oral treatment admitted to emergency service with elevated blood pressure
combination
patients prescribed combination agents for oral treatment admitted to emergency service with elevated blood pressure

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
routine use of oral antihypertensive agents and its effects on emergency service care
Time Frame: from enrollment to the end of follow up duration of 7 days
emergency service blood pressure target achievement duration changes depending on routine oral antihypertensive agent prescribed
from enrollment to the end of follow up duration of 7 days

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Saglik Bilimleri Universitesi

Collaborators

Etimesgut Military Hospital

Investigators

  • Study Director: Elif HAMZACEBIOGLU KAYISOGLU, Specialist, Etimesgut Military Hospital
  • Principal Investigator: Gulsen AKCAY, Ass. Prof., Ankara Etlik City Hospital

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

November 1, 2024

Primary Completion (Estimated)

November 1, 2025

Study Completion (Estimated)

November 1, 2025

Study Registration Dates

First Submitted

October 8, 2024

First Submitted That Met QC Criteria

October 8, 2024

First Posted (Actual)

October 10, 2024

Study Record Updates

Last Update Posted (Actual)

October 10, 2024

Last Update Submitted That Met QC Criteria

October 8, 2024

Last Verified

September 1, 2024

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • hypertension

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

product manufactured in and exported from the U.S.

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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