Practice patterns, outcomes, and end-organ dysfunction for patients with acute severe hypertension

The Studying the Treatment of Acute hyperTension (STAT) Registry

Jason N. Katz, Joel M. Gore, Alpesh Amin, Frederick A. Anderson, Joseph F. Dasta, James J. Ferguson, Kurt Kleinschmidt, Stephan A. Mayer, Alan S. Multz, W. Frank Peacock, Eric Peterson, Charles Pollack, Gene Yong Sung, Andrew Shorr, Joseph Varon, Allison Wyman, Leigh A. Emery, Christopher B. Granger

Research output: Contribution to journalArticle

57 Citations (Scopus)

Abstract

Background: Limited data are available on the care of patients with acute severe hypertension requiring hospitalization. We characterized contemporary practice patterns and outcomes for this population. Methods: STAT is a 25-institution, US registry of consecutive patients with acute severe hypertension (>180 mm Hg systolic and/or >110 mm Hg diastolic; >140 and/or >90 for subarachnoid hemorrhage) treated with intravenous therapy in a critical care setting. Results: One thousand five hundred eighty-eight patients were enrolled (January 2007 to April 2008). Median age was 58 years (interquartile range 49-70 years), 779 (49%) were women, and 892 (56%) were African American; 27% (n = 425) had a prior admission for acute hypertension and 486 (31%) had chronic kidney disease. Median qualifying blood pressure (BP) was 200 (186, 220) systolic and 110 (93, 123) mm Hg diastolic. Initial intravenous antihypertensive therapies used to control BP varied, with 1,009 (64%) patients requiring multiple drugs. Median time to achieve a systolic BP <160 mm Hg (<140 mm Hg for subarachnoid hemorrhage) was 4.0 (0.8, 12) hours; 893 (60%) had reelevation to >180 (>140 for subarachnoid hemorrhage) after initial control; and 63 (4.0%) developed iatrogenic hypotension. Hospital mortality was 6.9% (n = 109) with an aggregate 90-day mortality rate of 11% (174/1,588); 59% (n = 943) had acute/worsening end-organ dysfunction during hospitalization. The 90-day readmission rate was 37% (523/1,415), of which one quarter (132/523) was due to recurrent acute severe hypertension. Conclusion: This study highlights heterogeneity in care, BP control, and outcomes of patients hospitalized with acute severe hypertension.

Original languageEnglish (US)
JournalAmerican Heart Journal
Volume158
Issue number4
DOIs
StatePublished - Oct 2009

Fingerprint

Registries
Hypertension
Blood Pressure
Subarachnoid Hemorrhage
Hospitalization
Therapeutics
Critical Care
Hospital Mortality
Chronic Renal Insufficiency
African Americans
Hypotension
Antihypertensive Agents
Patient Care
Mortality
Pharmaceutical Preparations
Population

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Practice patterns, outcomes, and end-organ dysfunction for patients with acute severe hypertension : The Studying the Treatment of Acute hyperTension (STAT) Registry. / Katz, Jason N.; Gore, Joel M.; Amin, Alpesh; Anderson, Frederick A.; Dasta, Joseph F.; Ferguson, James J.; Kleinschmidt, Kurt; Mayer, Stephan A.; Multz, Alan S.; Peacock, W. Frank; Peterson, Eric; Pollack, Charles; Sung, Gene Yong; Shorr, Andrew; Varon, Joseph; Wyman, Allison; Emery, Leigh A.; Granger, Christopher B.

In: American Heart Journal, Vol. 158, No. 4, 10.2009.

Research output: Contribution to journalArticle

Katz, JN, Gore, JM, Amin, A, Anderson, FA, Dasta, JF, Ferguson, JJ, Kleinschmidt, K, Mayer, SA, Multz, AS, Peacock, WF, Peterson, E, Pollack, C, Sung, GY, Shorr, A, Varon, J, Wyman, A, Emery, LA & Granger, CB 2009, 'Practice patterns, outcomes, and end-organ dysfunction for patients with acute severe hypertension: The Studying the Treatment of Acute hyperTension (STAT) Registry', American Heart Journal, vol. 158, no. 4. https://doi.org/10.1016/j.ahj.2009.07.020
Katz, Jason N. ; Gore, Joel M. ; Amin, Alpesh ; Anderson, Frederick A. ; Dasta, Joseph F. ; Ferguson, James J. ; Kleinschmidt, Kurt ; Mayer, Stephan A. ; Multz, Alan S. ; Peacock, W. Frank ; Peterson, Eric ; Pollack, Charles ; Sung, Gene Yong ; Shorr, Andrew ; Varon, Joseph ; Wyman, Allison ; Emery, Leigh A. ; Granger, Christopher B. / Practice patterns, outcomes, and end-organ dysfunction for patients with acute severe hypertension : The Studying the Treatment of Acute hyperTension (STAT) Registry. In: American Heart Journal. 2009 ; Vol. 158, No. 4.
@article{e14482d373fd47b6b0ee2bd7d8c4b4ed,
title = "Practice patterns, outcomes, and end-organ dysfunction for patients with acute severe hypertension: The Studying the Treatment of Acute hyperTension (STAT) Registry",
abstract = "Background: Limited data are available on the care of patients with acute severe hypertension requiring hospitalization. We characterized contemporary practice patterns and outcomes for this population. Methods: STAT is a 25-institution, US registry of consecutive patients with acute severe hypertension (>180 mm Hg systolic and/or >110 mm Hg diastolic; >140 and/or >90 for subarachnoid hemorrhage) treated with intravenous therapy in a critical care setting. Results: One thousand five hundred eighty-eight patients were enrolled (January 2007 to April 2008). Median age was 58 years (interquartile range 49-70 years), 779 (49{\%}) were women, and 892 (56{\%}) were African American; 27{\%} (n = 425) had a prior admission for acute hypertension and 486 (31{\%}) had chronic kidney disease. Median qualifying blood pressure (BP) was 200 (186, 220) systolic and 110 (93, 123) mm Hg diastolic. Initial intravenous antihypertensive therapies used to control BP varied, with 1,009 (64{\%}) patients requiring multiple drugs. Median time to achieve a systolic BP <160 mm Hg (<140 mm Hg for subarachnoid hemorrhage) was 4.0 (0.8, 12) hours; 893 (60{\%}) had reelevation to >180 (>140 for subarachnoid hemorrhage) after initial control; and 63 (4.0{\%}) developed iatrogenic hypotension. Hospital mortality was 6.9{\%} (n = 109) with an aggregate 90-day mortality rate of 11{\%} (174/1,588); 59{\%} (n = 943) had acute/worsening end-organ dysfunction during hospitalization. The 90-day readmission rate was 37{\%} (523/1,415), of which one quarter (132/523) was due to recurrent acute severe hypertension. Conclusion: This study highlights heterogeneity in care, BP control, and outcomes of patients hospitalized with acute severe hypertension.",
author = "Katz, {Jason N.} and Gore, {Joel M.} and Alpesh Amin and Anderson, {Frederick A.} and Dasta, {Joseph F.} and Ferguson, {James J.} and Kurt Kleinschmidt and Mayer, {Stephan A.} and Multz, {Alan S.} and Peacock, {W. Frank} and Eric Peterson and Charles Pollack and Sung, {Gene Yong} and Andrew Shorr and Joseph Varon and Allison Wyman and Emery, {Leigh A.} and Granger, {Christopher B.}",
year = "2009",
month = "10",
doi = "10.1016/j.ahj.2009.07.020",
language = "English (US)",
volume = "158",
journal = "American Heart Journal",
issn = "0002-8703",
publisher = "Mosby Inc.",
number = "4",

}

TY - JOUR

T1 - Practice patterns, outcomes, and end-organ dysfunction for patients with acute severe hypertension

T2 - The Studying the Treatment of Acute hyperTension (STAT) Registry

AU - Katz, Jason N.

AU - Gore, Joel M.

AU - Amin, Alpesh

AU - Anderson, Frederick A.

AU - Dasta, Joseph F.

AU - Ferguson, James J.

AU - Kleinschmidt, Kurt

AU - Mayer, Stephan A.

AU - Multz, Alan S.

AU - Peacock, W. Frank

AU - Peterson, Eric

AU - Pollack, Charles

AU - Sung, Gene Yong

AU - Shorr, Andrew

AU - Varon, Joseph

AU - Wyman, Allison

AU - Emery, Leigh A.

AU - Granger, Christopher B.

PY - 2009/10

Y1 - 2009/10

N2 - Background: Limited data are available on the care of patients with acute severe hypertension requiring hospitalization. We characterized contemporary practice patterns and outcomes for this population. Methods: STAT is a 25-institution, US registry of consecutive patients with acute severe hypertension (>180 mm Hg systolic and/or >110 mm Hg diastolic; >140 and/or >90 for subarachnoid hemorrhage) treated with intravenous therapy in a critical care setting. Results: One thousand five hundred eighty-eight patients were enrolled (January 2007 to April 2008). Median age was 58 years (interquartile range 49-70 years), 779 (49%) were women, and 892 (56%) were African American; 27% (n = 425) had a prior admission for acute hypertension and 486 (31%) had chronic kidney disease. Median qualifying blood pressure (BP) was 200 (186, 220) systolic and 110 (93, 123) mm Hg diastolic. Initial intravenous antihypertensive therapies used to control BP varied, with 1,009 (64%) patients requiring multiple drugs. Median time to achieve a systolic BP <160 mm Hg (<140 mm Hg for subarachnoid hemorrhage) was 4.0 (0.8, 12) hours; 893 (60%) had reelevation to >180 (>140 for subarachnoid hemorrhage) after initial control; and 63 (4.0%) developed iatrogenic hypotension. Hospital mortality was 6.9% (n = 109) with an aggregate 90-day mortality rate of 11% (174/1,588); 59% (n = 943) had acute/worsening end-organ dysfunction during hospitalization. The 90-day readmission rate was 37% (523/1,415), of which one quarter (132/523) was due to recurrent acute severe hypertension. Conclusion: This study highlights heterogeneity in care, BP control, and outcomes of patients hospitalized with acute severe hypertension.

AB - Background: Limited data are available on the care of patients with acute severe hypertension requiring hospitalization. We characterized contemporary practice patterns and outcomes for this population. Methods: STAT is a 25-institution, US registry of consecutive patients with acute severe hypertension (>180 mm Hg systolic and/or >110 mm Hg diastolic; >140 and/or >90 for subarachnoid hemorrhage) treated with intravenous therapy in a critical care setting. Results: One thousand five hundred eighty-eight patients were enrolled (January 2007 to April 2008). Median age was 58 years (interquartile range 49-70 years), 779 (49%) were women, and 892 (56%) were African American; 27% (n = 425) had a prior admission for acute hypertension and 486 (31%) had chronic kidney disease. Median qualifying blood pressure (BP) was 200 (186, 220) systolic and 110 (93, 123) mm Hg diastolic. Initial intravenous antihypertensive therapies used to control BP varied, with 1,009 (64%) patients requiring multiple drugs. Median time to achieve a systolic BP <160 mm Hg (<140 mm Hg for subarachnoid hemorrhage) was 4.0 (0.8, 12) hours; 893 (60%) had reelevation to >180 (>140 for subarachnoid hemorrhage) after initial control; and 63 (4.0%) developed iatrogenic hypotension. Hospital mortality was 6.9% (n = 109) with an aggregate 90-day mortality rate of 11% (174/1,588); 59% (n = 943) had acute/worsening end-organ dysfunction during hospitalization. The 90-day readmission rate was 37% (523/1,415), of which one quarter (132/523) was due to recurrent acute severe hypertension. Conclusion: This study highlights heterogeneity in care, BP control, and outcomes of patients hospitalized with acute severe hypertension.

UR - http://www.scopus.com/inward/record.url?scp=70349208593&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=70349208593&partnerID=8YFLogxK

U2 - 10.1016/j.ahj.2009.07.020

DO - 10.1016/j.ahj.2009.07.020

M3 - Article

VL - 158

JO - American Heart Journal

JF - American Heart Journal

SN - 0002-8703

IS - 4

ER -