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<h2><strong>Title:</strong> <a href="https://umem.org/educational_pearls/4686/">What is the association of hypertension without end organ dysfunction and MACE in ED patients?</a></h2>
<p><strong>Category:</strong> <a href="https://umem.org/educational_pearls/?category=1">Cardiology</a></p>
<p><strong>Keywords:</strong> Hypertension, MACE, end organ <a href="http://www.ncbi.nlm.nih.gov/sites/entrez?cmd=search&term=Hypertension+MACE+end+organ+%22last+5+years%22[dp]&db=pubmed&pubmedfilters=true" target="_blank">(PubMed Search)<i class="icon-share" title="Opens in new window"></i></a> </p>
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<strong>Posted:</strong> 1/4/2025 by <a href="https://umem.org/educational_pearls/?author=2561">Robert Flint, MD</a>
<br/>
<a href="https://umem.org/profiles/faculty/2561/">Click here to contact Robert Flint, MD</a>
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<p>This study followed patients presenting to the ED with elevated (SBP>180, DBP>120) blood pressure without evidence of end organ dysfunction for one year. Â The patients were followed for major adverse cardiac events. They found:Â </p>
<p>“A total of 12,044 patients were enrolled. The prevalence of MACE within one year was 1,865 (15.5%). Older age, male gender, history of cardiovascular disease, cerebrovascular disease, diabetes, smoking, presentation with chest pain, altered mental status, dyspnea, treatment with intravenous and oral hydralazine, and oral metoprolol were independent predictors for one-year MACE. Additionally, discharge with an SBP ?160 mm Hg was not associated with 30-day MACE-free survival after propensity matching (hazard ratio 0.99, 95% confidence interval 0.78–1.25, P?=?0.92).â€</p>
<p>Treating to reach a magic number did not help. Most likely, long term control of blood pressure is a more important factor than attempts to lower in the ED. Â While this is a high risk group, there is no evidence that acute lowering of blood pressure impacts long term survival.</p>
<h3>References</h3>
<h3><a href="https://westjem.com/articles/emergency-department-blood-pressure-treatment-and-outcomes-in-adults-presenting-with-severe-hypertension.html"><strong>Emergency Department Blood Pressure Treatment and Outcomes in Adults Presenting with Severe Hypertension</strong></a></h3>
<ul>
<li>WestJem</li>
<li>
<a href="https://westjem.com/articles">ARTICLES</a> , <a href="https://westjem.com/current-issue-volume-25-issue-5">CURRENT ISSUE: VOLUME 25 ISSUE 5</a>
</li>
<li>
<strong>PUBLISHED:</strong> JULY 17, 2024</li>
<li>
<strong>DOI:</strong> 10.5811/WESTJEM.18126</li>
</ul>
<h3>View this pearl on the University of Maryland, Department of Emergency Medicine's website: <a href="https://umem.org/educational_pearls/4686/">https://umem.org/educational_pearls/4686/</a></h3>
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