Despite recent advances in general hypertension control, it was unclear whether the trends applied to the most severe kinds of hypertension—hypertensive crises requiring hospitalization—in both women and men at risk. For a study, researchers assessed sex-pooled and sex-specific temporal trends in hypertensive crisis hospitalization and case fatality rates using data from the National Inpatient Sample over 3 time periods: 2002 to 2006, 2007 to 2011, and 2012 to 2014. It was estimated somewhere between 918,392 and 9,331 hypertensive crisis hospitalizations and somewhere between 4,377 and 157 in-hospital fatalities throughout the study period (2002–2014). During the research period, hypertensive crises accounted for somewhere between 0.23% and 0.002% of all hospitalizations: between 0.24% and 0.002% for males and somewhere between 0.22% and 0.002% for women. In multivariable analyses that controlled for age, race or ethnicity and cardiovascular conditions, the odds of having a hypertensive crisis hospitalization increased annually for both men (OR, 1.083 per year; 95% CI, 1.08–1.09) and women (OR, 1.07 per year, 95% CI, 1.07–1.08), with men having a higher rate of increase (P<0.001). Men (OR, 0.89 per year; 95% CI, 0.86–0.92) and women (OR, 0.92 per year; 95% CI, 0.90–0.94) had identical multivariable-adjusted chances of death during hypertensive crisis hospitalization. Hospitalizations for hypertensive crises have gradually climbed, slightly more so among men than women, and there had been an increase in the burden of cardiovascular disease. The trends, observed despite widespread gains in hypertension prevention and control, called for more research to uncover contributory factors that could have been targeted with focused interventions.

 

Link:www.ahajournals.org/doi/10.1161/JAHA.121.021244