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“Short-term prognosis of hypertensive emergencies and urgencies: second preliminary report of the ongoing Italian multicenter ERIDANO study”

Hypertension Research (2026)Cite this article

Abstract

Hypertensive emergencies (HE) and urgencies (HU) are significant challenges for emergency physicians and hypertension specialists. The Eridano study is a prospective multicenter investigation assessing acute blood pressure (BP) disorders, subclinical hypertension-mediated organ damage (HMOD), and short- and long-term prognosis, including cardiovascular complications, new ED admissions, and BP control. Patients with symptomatic BP ≥ 180/110 mmHg admitted to the ED were enrolled and managed by ED personnel. Clinical evaluation and subclinical-HMOD assessment were performed at a Hypertension Centre within 72 h, followed by a 3-month follow-up. A total of 252 patients (21 HE, 231 HU) were included (mean age 61 ± 14 years, 52% males). Subclinical-HMOD was more common in HE (90% vs. 65%), including cardiac (76% vs. 43%), renal (40% vs. 11%), and cerebral (73% vs. 12%) damage. Vascular-HMOD was similar between the groups (54%), with increased pulse wave velocity (PWV) in 44% of patients. BP control (<140/90 mmHg) was achieved in 36% at 72 h. At 3 months, both groups showed lower systolic BP, and 29% of patients with uncontrolled BP at baseline achieved control. Female sex, lower ascending aorta diameter, and lower E/e’ ratio were associated with BP control. The composite endpoint (cardiovascular events and new ED admissions) occurred in 12% of patients at 3 months (4% major events, 7% new HU). Multivariate analysis showed female sex and PWV were associated with adverse outcomes. Two-thirds of patients had subclinical HMOD, primarily affecting large arteries and the heart. Female sex and PWV were associated with worse outcomes.

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Acknowledgements

We are grateful to staff physicians and fellows of the Emergency departments and Hypertensive centers for their work. We also thank Michela Algeri, Arianna Ardito, Giordano Bianchi, Saverio Fabbri, Claudio Pascale, Alessandra Piazza, Giuliano Pinna, Giovanni Saccà, and Nicole Saxinger for essential collaboration and useful discussion.

Eridano Consortium

Dario Leone1,2, Salvatore Fragapani1,2, Giulia Bruno1,2, Giulia Mingrone1,2, Anna Colomba1,2, Jacopo Ligato1,2, Elvira Fanelli1,2, Lorenzo Airale2, Arianna Paladino1,2, Francesca Novello1,2, Enrico Lupia9, Fulvio Morello9, Maria Tizzani9, Antonella Ioverno3, Paola Sormani4, Carmine De Luca5, Raffaele Izzo5, Nicola De Luca5, Nicola Nesti8

Author information

Author notes

  1. These authors contributed equally: Fabrizio Vallelonga, Marco Cesareo.

Authors and Affiliations

  1. Division of Internal Medicine, Candiolo Cancer Institute FPO-IRCCS, Candiolo (Turin), Italy

    Fabrizio Vallelonga, Alberto Milan, Dario Leone, Salvatore Fragapani, Giulia Bruno, Giulia Mingrone, Anna Colomba, Jacopo Ligato, Elvira Fanelli, Arianna Paladino & Francesca Novello

  2. Department of Medical Sciences, University of Turin, Turin, Italy

    Fabrizio Vallelonga, Marco Cesareo, Martina Sanapo, Alberto Milan, Dario Leone, Salvatore Fragapani, Giulia Bruno, Giulia Mingrone, Anna Colomba, Jacopo Ligato, Elvira Fanelli, Lorenzo Airale, Arianna Paladino & Francesca Novello

  3. Clinic of Emergency Medicine, Department of Internal Medicine, IRCCS Ospedale Policlinico San Martino, University of Genoa, Genoa, Italy

    Barbara Maria Colombo, Aldo Pende & Antonella Ioverno

  4. University of Milan-Bicocca, Milan, Italy and Cardiology 4, ASST GOM Niguarda Hospital, Milan, Italy

    Alessandro Maloberti, Cristina Giannattasio & Paola Sormani

  5. Department of Advanced Biomedical Science, Hypertension Research Center, “Federico II” University Hospital of Naples, Naples, Italy

    Ilaria Fucile, Costantino Mancusi, Carmine De Luca, Raffaele Izzo & Nicola De Luca

  6. Department of Internal Medicine, A.O. Ordine Mauriziano, Turin, Italy

    Silvia Totaro

  7. Department of Internal Medicine, ASST Spedali Civili of Brescia, University of Brescia, Brescia, Italy

    Carlo Aggiusti, Massimo Salvetti & Maria Lorenza Muiesan

  8. Department of Medical Specialties, AUSL Toscana Centro, Internal Medicine Unit, San Marcello e San Jacopo I Hospital, Pistoia, Italy

    Franco Cipollini & Nicola Nesti

  9. Emergency Medicine Unit, Città della Salute e della Scienza Hospital, Department of Medical Sciences, University of Turin, Turin, Italy

    Enrico Lupia, Fulvio Morello & Maria Tizzani

Authors
  1. Fabrizio Vallelonga
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  2. Marco Cesareo
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  3. Martina Sanapo
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  4. Barbara Maria Colombo
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  14. Maria Lorenza Muiesan
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  15. Alberto Milan
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Consortia

Eridano Consortium

  • Dario Leone
  • , Salvatore Fragapani
  • , Giulia Bruno
  • , Giulia Mingrone
  • , Anna Colomba
  • , Jacopo Ligato
  • , Elvira Fanelli
  • , Lorenzo Airale
  • , Arianna Paladino
  • , Francesca Novello
  • , Enrico Lupia
  • , Fulvio Morello
  • , Maria Tizzani
  • , Antonella Ioverno
  • , Paola Sormani
  • , Carmine De Luca
  • , Raffaele Izzo
  • , Nicola De Luca
  •  & Nicola Nesti

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Correspondence to Fabrizio Vallelonga.

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Vallelonga, F., Cesareo, M., Sanapo, M. et al. “Short-term prognosis of hypertensive emergencies and urgencies: second preliminary report of the ongoing Italian multicenter ERIDANO study”. Hypertens Res (2026). https://doi.org/10.1038/s41440-026-02586-9

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