Long term prognosis of hypertensive emergency
What is the long term prognosis of patients with a hypertensive emergency?
Patients who experience a hypertensive emergency or urgency have worse outcomes than those whose blood pressure is chronically well controlled, but there are several confounders. With prompt and effective therapy, the prognosis in hypertensive emergencies depends more on kidney function at presentation (the higher the serum creatinine, the greater the risk of dialysis). The other important factor is the willingness/ability of the patient to take prescription antihypertensive drugs, as nonadherence is now the most common antecedent to hypertensive emergencies. Although the prognosis was dismal (∼10% 1-year survival) before antihypertensive drug therapy was available, most recent series show higher than 95% 1-year survival rates. Although kidney function sometimes deteriorates acutely during and after blood pressure lowering (except, perhaps, with fenoldopam), some patients have recovered enough kidney function to discontinue dialysis after the blood pressure was well controlled on an outpatient basis.
