Characteristics of XXXX That Do Not Initially Respond to Intravenous Antihypertensives in the Emergency Department: Subanalysis of the CLUE Trial.

@entity1 @entity64 @entity101 @entity6555 @entity16 @entity3360
INTRODUCTION: @entity101 emergency has a high mortality risk and the treatment goal is to quickly lower blood pressure with intravenous (IV) medications. Characteristics that are associated with non-response to IV antihypertensives have not been identified. The objective is to identify @entity1 characteristics associated with resistance to IV antihypertensives. METHODS: This was a subanalysis of @entity1 enrolled in the previously described comparative effectiveness trial of IV @entity3360 vs. @entity6555 use in the emergency department (CLUE) study, a randomized trial of @entity3360 vs. @entity6555 . Non-responders were defined as those @entity1 who did not achieve target systolic blood pressure (SBP), as set by the treating physician, within thirty minutes of IV antihypertensive medication, +/- 20mmHg. Stepwise logistic regression was used to identify covariates associated with the measurement outcomes. RESULTS: CLUE enrolled 226 @entity1 , 52.7% female, 76.4% black, mean age of 52.6  14.6 years, of whom 110 were treated with @entity3360 and 116 with @entity6555 . The median (IQR) initial systolic blood pressure was 211mmHg (198, 226), 210 (200, 230), and 211mmHg (198, 226), for the total, non-responder, and responder cohorts, respectively (p-value=0.65, 95% CI [-5.8-11.3]). Twenty-nine were non-responders, 9 in the @entity3360 and 20 in the @entity6555 group. In univariate analysis, several symptoms suggestive of @entity16 were associated with non-response. After multiple variable logistic regression (AUC = 0.72), treatment with @entity6555 (OR 2.7, 95% CI [1.1-6.7]), history of @entity64 (OR 5.4, 95% CI [1.6-18.5]), and being male (OR 3.3, 95% CI [1.4-8.1]) were associated with failure to achieve target blood pressure. CONCLUSION: Male gender and history of previous @entity64 are associated with difficult to control blood pressure.
