Profile of patients admitted for acute hypertensive heart failure

Abstract

Acute heart failure is one of the most common hospitalization situations in the world. High blood pressure or so-called hypertensive heart disease is the second leading cause. The aim of this work is to study the epidemiological, clinical, and paraclinical profile of patients admitted for acute hypertensive heart failure. This is a retrospective study conducted on 350 admitted patients, in the cardiology department of Ibn Rochd CHU, for acute heart failure. We excluded patients admitted for emergency hypertensive hemorrhagic stroke type. The diagnosis was made on acute heart failure with high blood pressure at admission (more than 140 mmHg). Hypertensive emergency was noted in 88 patients or 25.1% of patients admitted for AHF. The average age was 61 ± 11 years with male predominance of 81%. Two-thirds of the patients were not known hypertensive. One-third of patients had diabetes, one-third had chronic tobacco and one-third had a history of myocardial infarction. Clinically, 56 patients with isolated left-ventricular hypertensive insufficiency, 18 patients had unstable angina associated, 12 patients had aortic dissection, 2 patients had hypertensive encephalopathy, mean systolic blood pressure was 230 mmHg, mean diastolic 140 mmHg. Signs of right heart failure were also present in 62% of cases. All patients had high filling pressures and grade II diastolic dysfunction in 53%. From a biological point of view, the average glomerular filtration rate was 50 mL/min/1.73 m 2 . Renal failure with GFR below 30 mL/min/1.73m 2 was marked in 60%. We did not notice any deaths in our series. the hypertensive emergency constitutes a quarter of the patients admitted for AHF. It occurs rather in an unknown population hypertensive characterized by the presence of the risk factors such as diabetes, tobacco and IDM ATCD. This syndrome poses in our context a problem of management of associated comorbidities.