Analiza przyczyn hospitalizacji i rodzaju leczenia pacjentów z nadciśnieniem tętniczym Analysis of causes of hospitalizations and type of hypotensive therapy in patients with essential hypertension

Summary Background Cardiovascular diseases are the main cause of morbidity and mortality. Hypertension is the major risk factor for cardiovascular complications. The aim of the study was to assess the causes of hospitalization and type of hypotensive therapy in patients with essential hypertension (ICD10) admitted to the Cardiology Unit of Voivodeship Hospital in Suwalki in 2007. Material and methods There were 1395 patients hospitalized in the cardiology unit in 2007, including 61% of patients with hypertension. Only 90 patients (7%, 70% of females, age range 18–79 years) were admitted to the hospital with the diagnosis of hypertension. At admission in 58% blood pressure values exceeded 180/110 mm Hg. In none of the patients target blood pressure values were found. The most common comorbid conditions were: coronary artery disease in 42,2%, peripheral artery disease in 20%, dyslipidemia in 50%, abnormal glucose metabolism in 33%, cerebrovascular events in 13%, chronic kidney disease in 28%, obesity in 50%. Up to 80% of cases were admitted to the hospital as urgent. Results Half of the patients were sent to the hospital by family physicians, 22% by cardiologists, 15% by an ambulance service. During hospitalization over the half of the patients were treated with more than 3 hypotensive drugs, including angiotensin converting enzyme inhibitors (87.7%), diuretics (85.5%), b-blockers (82.2%) and calcium channel blockers (75.5%). Moreover, 83.3% were given acetylsalicylic acic, 57.7% were given statins, and 47.7% were administered potassium supplements. At discharge, 89% had blood pressure values below 140/90, including 32% with blood pressure values below 120/80 mm Hg. Conclusions Concluding, despite high prevalence of hypertension, blood pressure control is still insufficient. Comorbidities are common in hypertensive patients and they are not adequately treated. Taking all these facts into consideration there is a strong rationale for establishment of hypertension outpatient unit at the hospital with dedicated medical staff.