Evidence map›Paper›PMID 38481132›Full record

ArticleBMC cardiovascular disorders2024

In emergency hypertension, could biomarkers change the guidelines?

Mohammad El Tahlawi, Scopus Mohamed Ismail, Ahmed Eldamanhory, Ayman Khorshed, Salem M Salem

Open access · goldAbstract read
In one paragraph

Article in BMC cardiovascular disorders, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.8field-weighted citation impact, top 27% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 2 citations in OpenAlex.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 2 institutions in 2 countries.

Mohammad El TahlawiZagazig University Hospitals, Zagazig, Egypt. tahlawi_basha@yahoo.com.
Scopus Mohamed IsmailZagazig University Hospitals, Zagazig, Egypt.
Ahmed EldamanhoryZagazig University Hospitals, Zagazig, Egypt.
Ayman KhorshedZagazig University Hospitals, Zagazig, Egypt.
Salem M SalemZagazig University Hospitals, Zagazig, Egypt.
Zagazig University · EGMayo Clinic in Arizona · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundHypertension may cause target organ damage (TOD). Target blood pressure (BP) management may not be appropriate in some conditions.

aimWe aim to assess the impact of targeted BP management in severe hypertension on renal TOD. PATIENTS &

methodsThis is a prospective cohort study involving patients admitted due to severe hypertension (BP > 180/120) associated with any symptoms. The study involved patients referred to the ICU in our tertiary center during the period between August 2017 and February 2018. All patients underwent target BP treatment according to recent guidelines. Hs-Troponin T (hs-TNT) and serum creatinine (s.creat) were measured in all patients on admission and 24 h later. Patients were divided into Group A (with initial normal hs-TNT) and Group B (with initial high hs-TNT). The main outcome was in-hospital renal-related morbidity (including renal failure).

resultsFour hundred seventy consecutive patients with hypertensive crises were involved in the study. Group B had a significantly higher incidence of in-hospital mortality (4 patients) and renal TOD (acute renal dysfunction) than Group A (P value = 0.001 and 0.000 respectively). There was a significant difference between initial s.creat on admission and follow-up s.creat values in Group B with significant elevation of their s.creat on the following 24 h (P = 0.002), while this difference is insignificant in Group A (P = 0.34). There was a significant positive correlation between hs-TNT and the follow-up s.creat (P = 0.004).

conclusionIn severe HTN, hs-TNT may be elevated due to marked afterload. Patients with severe HTN and high hs-TNT have higher s.creat values, which are associated with an increased risk of renal failure and in-hospital mortality if their BP decreases acutely to the guideline-target BP. Using biomarkers during the management of emergency HTN should be considered before following clinical guidelines. However, our findings do underscore the potential utility of hs-TNT as an indicator for risk stratification in patients with severe or emergency HTN.

Indexed as

HypertensionRenal InsufficiencyBiomarkersHumansPrognosisProspective StudiesTroponin TBiomarkersTroponin TBiomarkerEmergency hypertensionRenal failureTarget blood pressureTarget organ damageTroponin

Identifiers

PMID38481132
PMCPMC10935803
OpenAlexW4392741723

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.