“Short-term prognosis of hypertensive emergencies and urgencies: second preliminary report of the ongoing Italian multicenter ERIDANO study”

Hypertensive emergencies (HE) and urgencies (HU) are significant challenges for emergency physicians and hypertension specialists. The Eridano study is a prospective multicenter investigation assessing acute blood pressure (BP) disorders, subclinical hypertension-mediated organ damage (HMOD), and short- and long-term prognosis, including cardiovascular complications, new ED admissions, and BP control. Patients with symptomatic BP ≥ 180/110 mmHg admitted to the ED were enrolled and managed by ED personnel. Clinical evaluation and subclinical-HMOD assessment were performed at a Hypertension Centre within 72 h, followed by a 3-month follow-up. A total of 252 patients (21 HE, 231 HU) were included (mean age 61 ± 14 years, 52% males). Subclinical-HMOD was more common in HE (90% vs. 65%), including cardiac (76% vs. 43%), renal (40% vs. 11%), and cerebral (73% vs. 12%) damage. Vascular-HMOD was similar between the groups (54%), with increased pulse wave velocity (PWV) in 44% of patients. BP control (<140/90 mmHg) was achieved in 36% at 72 h. At 3 months, both groups showed lower systolic BP, and 29% of patients with uncontrolled BP at baseline achieved control. Female sex, lower ascending aorta diameter, and lower E/e’ ratio were associated with BP control. The composite endpoint (cardiovascular events and new ED admissions) occurred in 12% of patients at 3 months (4% major events, 7% new HU). Multivariate analysis showed female sex and PWV were associated with adverse outcomes. Two-thirds of patients had subclinical HMOD, primarily affecting large arteries and the heart. Female sex and PWV were associated with worse outcomes. (Figure presented.)