Risk factors promoting hypertensive crises: evidence from a longitudinal study

Saguner, Ardan M; Dür, Stefan; Perrig, Martin; Schiemann, Uwe; Stuck, Andreas E; Bürgi, Ulrich; Erne, Paul; Schoenenberger, Andreas W (2010). Risk factors promoting hypertensive crises: evidence from a longitudinal study. American journal of hypertension, 23(7), pp. 775-780. Oxford: Oxford University Press 10.1038/ajh.2010.71

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Current knowledge about risk factors promoting hypertensive crisis originates from retrospective data. Therefore, potential risk factors of hypertensive crisis were assessed in a prospective longitudinal study.


Eighty-nine patients of the medical outpatient unit at the University Hospital of Bern (Bern, Switzerland) with previously diagnosed hypertension participated in this study. At baseline, 33 potential risk factors were assessed. All patients were followed-up for the outcome of hypertensive crisis. Cox regression models were used to detect relationships between risk factors and hypertensive crisis (defined as acute rise of systolic blood pressure (BP) ≥200mmHg and/or diastolic BP ≥120mmHg).


The mean duration of follow-up was 1.6 ± 0.3 years (range 1.0–2.4 years). Four patients (4.5%) were lost to follow-up. Thirteen patients (15.3%) experienced hypertensive crisis during follow-up. Several potential risk factors were significantly associated with hypertensive crisis: female sex, higher grades of obesity, the presence of a hypertensive or coronary heart disease, the presence of a somatoform disorder, a higher number of antihypertensive drugs, and nonadherence to medication. As measured by the hazard ratio, nonadherence was the most important factor associated with hypertensive crisis (hazard ratio 5.88, 95% confidence interval 1.59–21.77, P < 0.01).


This study identified several potential risk factors of hypertensive crisis. Results of this study are consistent with the hypothesis that improvement of medical adherence in antihypertensive therapy would help to prevent hypertensive crises. However, larger studies are needed to assess potential confounding, other risk factors and the possibility of interaction between predictors.

Item Type:

Journal Article (Original Article)


04 Faculty of Medicine > Department of General Internal Medicine (DAIM) > Clinic of General Internal Medicine > Centre of Competence for General Internal Medicine
04 Faculty of Medicine > Department of General Internal Medicine (DAIM) > Geriatric Clinic

UniBE Contributor:

Saguner, Ardan Muammer, Dür, Stefan, Perrig, Martin, Schiemann, Uwe Kurt, Stuck, Andreas, Bürgi, Ulrich, Schoenenberger, Andreas




Oxford University Press




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04 Oct 2013 14:08

Last Modified:

05 Dec 2022 14:00

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https://boris.unibe.ch/id/eprint/323 (FactScience: 197577)

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