Clinical trial NCT00005240: Epidemiology of Hypertensive Emergency
Official title: Correlates of Nonadherence to Hypertension Treatment in an Inner-City Minority Population
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: Cardiovascular Diseases
Heart Diseases
Hypertension
Lead sponsor: Columbia University
Sponsor class: OTHER
Collaborators: name: National Heart, Lung, and Blood Institute (NHLBI)
First posted: 2000-05-26
Enrollment: 210
Sex: ALL
Minimum age (years): 21
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Observational model: CASE_CONTROL
Time perspective: PROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: Subjects were enrolled in a case-control study of hypertensive emergency and urgency. Cases were patients with incidents of hypertensive emergency or hypertensive urgency, and controls were hypertensive patients with other acute conditions who were admitted to the hospital or were treated in the emergency room and released.

Brief summary: To test the hypotheses that hypertensive emergency was associated with non-compliance with antihypertensive medication, low level of contact with the medical care system, and alcohol abuse and cigarette smoking. Also, to describe the clinical characteristics of patients hospitalized with hypertensive emergency including morbidity, mortality, and cost, and the extent to which hypertensive emergency occured among previously diagnosed and treated hypertensives.

Detailed description: BACKGROUND:

While less frequent than in the era before effective treatment for hypertension, hypertensive emergency remains a relatively common cause of hospital admission in some sub-populations. In 1989, hypertensive emergency accounted for approximately 60 admissions per year to the Medical Service at Presbyterian Hospital, and a somewhat higher proportion of intensive care unit admissions and utilization. The importance of hypertensive emergency may have been underestimated because the International Classification of Diseases discharge codes included only malignant hypertension, a severe form comprising only about half of the admissions for hypertensive emergency. There had been almost no epidemiologic studies of hypertensive emergency since 1969, and very little was known about risk factors.

DESIGN NARRATIVE:

A matched case-control study design was used. Cases were obtained from admissions to the Medical Service at Presbyterian Hospital. Morbidity and mortality data were obtained by follow-up of the case series.

Eligibility criteria: Inclusion criteria

1. Patients admitted in the emergency room and for the medical and surgical services at the Presbyterian Hospital and Harlem Hospital Center in New York City

* patients with incidents of hypertensive emergency or hypertensive urgency
* hypertensive patients with other acute conditions who were admitted to the hospital or were treated in the emergency room and released

Exclusion criteria

1. Under 21 years of age
2. Pregnancy

Primary outcomes:
Secondary outcomes:
Other outcomes:
Locations:
city: New York
country: United States
facility: Columbia University
state: New York
Study officials:
affiliation: Hamilton Southworth Professor of Medicine and Professor of Epide, Dept of Medicine General Medicine
name: Steven Shea, MD
role: PRINCIPAL_INVESTIGATOR
References:
citation: Shea S, Misra D, Ehrlich MH, Field L, Francis CK. Correlates of nonadherence to hypertension treatment in an inner-city minority population. Am J Public Health. 1992 Dec;82(12):1607-12. doi: 10.2105/ajph.82.12.1607.
citation: Shea S, Misra D, Ehrlich MH, Field L, Francis CK. Predisposing factors for severe, uncontrolled hypertension in an inner-city minority population. N Engl J Med. 1992 Sep 10;327(11):776-81. doi: 10.1056/NEJM199209103271107.