Triggering factors of hypertensive emergencies in the urban environment: an observational study in the prehospital setting

Abstract

Introduction Hypertensive emergencies represent a major public health problem, being associated with an increased risk of acute cardiovascular complications and mortality. In the context of the rising prevalence of arterial hypertension, identifying the triggering factors of hypertensive crises becomes essential for optimizing preventive interventions and management in the prehospital setting. Behavioral and psycho-emotional factors can significantly influence the occurrence of these acute episodes; however. Aim of the study Assessment of the triggering factors of hypertensive emergencies in urban patients who sought emergency medical care in the prehospital setting. Material and methods The study was a selective, descriptive cross-sectional observational study, including a sample of 418 patients with hypertensive emergencies from the urban area, who received care from the Emergency Medical Service in the prehospital setting. The inclusion criteria were: patients with hypertensive emergencies in the prehospital stage; patients aged over 18 years; and informed consent provided by the patient or by first-degree relatives for participation in the study. Descriptive statistics (frequencies, percentages, 95% CI) were used, and group comparisons were performed using the chi-square (χ²) test; p<0.05 was considered statistically significant. Results As a triggering factor for hypertensive crisis, almost all patients reported psychoemotional stress – 414 (99.0%; 95% CI [98.1-99.8]). For approximately two-thirds of the patients, physical inactivity was identified as a triggering factor – 283 (67.7%; 95% CI [63.2-72.2]) cases. Other factors had a considerably smaller contribution to the development of hypertensive episodes. Although women appeared to report hereditary factors more frequently as triggers for hypertensive crises – 48 (20.8%; 95% CI [15.7-26.9]) cases versus 26 (13.9%; 95% CI [9.0-19.0]) in men, as well as excessive salt intake – 36 (15.6%; 95% CI [11.0-20.4]) cases versus 20 (10.7%; 95% CI [6.5-15.4]) in men, no statistically significant differences were found for either of these factors (χ²=3.353; df=1; p=0.067) and (χ²=2.992; df=1; p=0.224), respectively. At the same time, excessive alcohol consumption was reported by only one male patient (0.5%; 95% CI [0.0-1.7]), which does not indicate a statistically significant difference between sexes (χ²=1.238; df=1; p=0.266). Conclusion The study highlights the dominant role of psychoemotional stress as a triggering factor for hypertensive crises, being reported by almost all patients. Physical inactivity is an important factor, present in more than two-thirds of cases. The results emphasize the need for interventions focused on stress reduction and the promotion of an active lifestyle in the prevention of hypertensive emergencies.