Hypertension Management in Terms of Routine Agents

NCT ID: NCT06635616

Last Updated: 2024-10-10

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

NOT_YET_RECRUITING

Total Enrollment

350 participants

Study Classification

OBSERVATIONAL

Study Start Date

2024-11-01

Study Completion Date

2025-11-01

Brief Summary

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known hypertensive patients admitted to emergency department with increased blood pressure will be evaluated in terms of antihypertensive agents given at hospital, degree of blood pressure decrease, hospital stay and laboratory and imaging tests ordered. The impact of routine oral antihypertensive agents used by the patients on these parameter will be assessed.

Detailed Description

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Hypertensive patients account for approximately 1-25% of annual emergency department visits . While this figure varies by region, hypertensive patients are among the groups that contribute significantly to emergency department crowding and workload . Hypertensive emergencies constitute about 0.3-0.9% of all patients, and this number is rapidly increasing each year .

The 2017 AHA hypertension guidelines emphasize that severe elevations in blood pressure (hypertensive crisis and hypertensive urgency) do not require emergency department visits or referrals unless there is end-organ damage . It is noted that treatment in these patients typically involves dose adjustment or a change in medication .

The 2023 ESC hypertension guidelines recommend that in patients presenting to the emergency department with a hypertensive crisis, blood pressure should be gradually lowered with oral agents over a 24-48 hour period. These patients do not usually require hospital admission but can be monitored in an outpatient setting for clinical evaluation. It is noted that their blood pressure may remain elevated upon discharge from the emergency department, and follow-up in a clinic is necessary for reevaluation of chronic therapy .

Some studies have indicated that both oral and intravenous treatments are preferred for patients presenting with hypertensive crises, highlighting that the approach can vary from physician to physician .

When evaluating literature reviews, published guidelines, and conducted studies, it is observed that there are differences between European and American approaches in defining and treating hypertensive crisis, as well as variability in physician management of these patients .

In our study, we plan to evaluate the effect of emergency department treatment on lowering blood pressure in known hypertensive patients (≥140/80) without end-organ damage. Additionally, we aim to assess the impact of the antihypertensive agents that patients routinely use on their length of stay in the emergency department, as well as the frequency and effectiveness of the medications used, and the target blood pressure values achieved post-treatment according to guidelines.

Conditions

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Hypertension Emergency Medicine

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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diuretics

patients prescribed diuretics for oral treatment admitted to emergency service with elevated blood pressure

No interventions assigned to this group

Beta Blockers

patients prescribed Beta Blockers for oral treatment admitted to emergency service with elevated blood pressure

No interventions assigned to this group

Calcium Channel Blockers

patients prescribed Calcium Channel Blockers for oral treatment admitted to emergency service with elevated blood pressure

No interventions assigned to this group

ACE (angiotensin converting enzyme) Inhibitors

patients prescribed ACE (angiotensin converting enzyme) Inhibitors for oral treatment admitted to emergency service with elevated blood pressure

No interventions assigned to this group

ARB( angiotensin receptor blockers)

patients prescribed ARB( angiotensin receptor blockers) for oral treatment admitted to emergency service with elevated blood pressure

No interventions assigned to this group

combination

patients prescribed combination agents for oral treatment admitted to emergency service with elevated blood pressure

No interventions assigned to this group

Eligibility Criteria

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Inclusion Criteria

1. Patients aged 18 and older.
2. Blood pressure measured at ≥140/80.
3. Diagnosis of essential hypertension.

Exclusion Criteria

1. Pregnant patients.
2. Individuals without a prior diagnosis of hypertension.
3. Patients with end-organ damage (hypertensive emergency).
4. Patients whose routine antihypertensive agents are unavailable.
5. Patients who leave the clinic without permission, making follow-up data inaccessible.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Etimesgut Military Hospital

OTHER

Sponsor Role collaborator

Saglik Bilimleri Universitesi

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Elif HAMZACEBIOGLU KAYISOGLU, Specialist

Role: STUDY_DIRECTOR

Etimesgut Military Hospital

Gulsen AKCAY, Ass. Prof.

Role: PRINCIPAL_INVESTIGATOR

Ankara Etlik City Hospital

Locations

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Etlik City Hospital

Ankara, , Turkey (Türkiye)

Site Status

Etimesgut Military Hospital

Ankara, , Turkey (Türkiye)

Site Status

Countries

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Turkey (Türkiye)

Central Contacts

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Gulsen AKCAY, Ass. Prof.

Role: CONTACT

+905052874949

Elif HAMZACEBIOGLU KAYISOGLU, Specialist

Role: CONTACT

+905453300679

Facility Contacts

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Gulsen AKCAY, ass. prof.

Role: primary

+905052874949

Ilker SIRIN, Specialist

Role: backup

+905414684309

Elif HAMZACEBIOGLU KAYISOGLU, Specialist

Role: backup

Gulsen AKCAY, ass.prof.

Role: backup

Ilker SIRIN, Specialist

Role: backup

Fatma BUYUKCELEN CIFTCI, Resident

Role: backup

Fatma Nur KOC, Resident

Role: backup

Bedriye Muge SONMEZ, ass. prof.

Role: backup

Elif HAMZACEIOGLU KAYISOGLU, Specialist

Role: primary

+905453300679

References

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Salvetti M, Paini A, Colonetti E, Tarozzi L, Bertacchini F, Aggiusti C, Stassaldi D, Rosei CA, Rosei EA, Muiesan ML. Hypertensive emergencies and urgencies: a single-centre experience in Northern Italy 2008-2015. J Hypertens. 2020 Jan;38(1):52-58. doi: 10.1097/HJH.0000000000002213.

Reference Type BACKGROUND
PMID: 31415308 (View on PubMed)

Nowicki J, Silka W, Zalustowicz A, Rajzer M, Olszanecka A. Uncontrolled hypertension and hypertensive urgency: One-year single-center emergency department experience. Kardiol Pol. 2024;82(4):407-415. doi: 10.33963/v.phj.100025. Epub 2024 Apr 12.

Reference Type BACKGROUND
PMID: 38606743 (View on PubMed)

Astarita A, Covella M, Vallelonga F, Cesareo M, Totaro S, Ventre L, Apra F, Veglio F, Milan A. Hypertensive emergencies and urgencies in emergency departments: a systematic review and meta-analysis. J Hypertens. 2020 Jul;38(7):1203-1210. doi: 10.1097/HJH.0000000000002372.

Reference Type BACKGROUND
PMID: 32510905 (View on PubMed)

Other Identifiers

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hypertension

Identifier Type: -

Identifier Source: org_study_id

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