Background: Hypertensive urgency is a common presentation in the emergency room (ER). Current practice guidelines suggest that it is not necessary to meet a strict blood pressure (BP) target in ER. But patients should achieve the BP goal within weeks or a few months. However, there is limited data on the follow-up BP outcome and its determinants.

Objective: To evaluate factors associated with successful BP control for hypertensive urgency patients after a 12-week treatment.

Materials and Methods: A retrospective cohort study conducted at a university hospital in the Northeast of Thailand from 1st January 2012 to 31st December 2016. We enrolled hypertensive urgency patients who visited ER and received standard treatment and followed-up in the Hypertensive Crisis Clinic for 12 weeks.

Results: A successful BP control (<140/90 mmHg) was observed in 129 patients (56.1%). The factor that associated with a successful BP control was the achievement of three-lifestyle modification including medication adherence, aerobic exercise, and salt restriction (OR 1.79; 95% CI, 1.01 to 3.19; p = 0.048), not the baseline BP, number of medication, and underlying diseases.

Conclusion: Lifestyles modification was an effective strategy to achieve a targeted BP in the hypertensive urgency patient. Therefore, patients should be educated and encouraged to have healthy lifestyles.

Keywords: Hypertensive crisis, Emergency, Lifestyles modification, Thai, Salt restriction