Berlin, 28-30 January, 2009: Acute severe hypertension is currently inadequately managed and its impact underestimated, agreed specialists in intensive care and cardiology at a multidisciplinary meeting on acute care, where a new European registry – EUROSTAT – was launched to collect data on the issue.
Fifty leading specialists in cardiology and intensive care from countries across Europe met at the meeting, Critical Care Innovation Global Perspective-2 (28-30 January, Berlin), to discuss emerging issues in the clinical management and processes of delivering care in critically ill patients.
Christopher Granger, Professor of Medicine and Director of the Cardiac Care Unit at Duke University Medical Center, Durham, USA, reported latest findings from the STAT (Studying the Treatment of Acute hyperTension) registry showing that acute hypertension (blood pressure > 180/110 mmHg) was associated with a mortality rate similar to acute coronary syndromes and acute heart failure. Despite this, many patients are not followed up after their initial treatment, he warned.
The US registry was the first multicentre study to explore the outcomes of acute hypertension, including 1599 patients from 25 hospitals. Results showed that mortality was 11% at 90 days, and 37% of patients were rehospitalised with acute hypertension over this period. More than half of the patients in the registry (57%) had no documented follow-up visit up to 90 days.
“The single most important message from the STAT registry is that these patients have really bad outcomes, with high mortality and recurrence rates,” said Professor Granger.
The new EUROSTAT registry will collect retrospective data on the treatment of acute hypertension in 3000 patients treated with intravenous antihypertensive agents in 100 hospitals across ten European countries. The aim is to collect data to explore how patients are treated and the standards of care currently operating in European hospitals.
Alain Vuylsteke, Director of Anaesthetic Research and Critical Care, Papworth Hospital NHS Foundation Trust, Cambridge, UK, and co-chair of EUROSTAT, said: “The registry will give us a lot of data to characterise acute hypertension in patients in emergency rooms, operating rooms and intensive care units in European centres. There is likely to be great variability in their management.” He added: “It is important to determine the full impact of controlling acute hypertension on patient outcomes.”
Delegates at the meeting, which was supported by an educational grant from The Medicines Company, who is also providing funding for the registries, agreed that it would be useful to develop guidelines on the management of acute hypertension, including recommendations for different subsets of patients based on underlying pathophysiology. A group agreed to review the available evidence and develop recommendations.
Written by Susan Mayor PhD, freelance medical journalist, London, UK
susanmayor(at)mac.com