Hospitalization Rates Increase for Uncontrolled Hypertension

Although men are more likely than women to be admitted for a hypertensive crisis, women have similar hospital mortality rates.

The number of patients hospitalized for a hypertensive crisis more than doubled between 2002 and 2014, according to researchers at Cedars-Sinai Medical Center. Furthermore, researchers found that although men are more likely than women to be admitted for a hypertensive crisis, women have similar hospital mortality rates.

According to the study authors, the increase in hospitalizations occurred during a time in which some studies reported overall progress in blood pressure control as well as a decline in related cardiovascular events in the United States. The new findings were published in the Journal of the American Heart Association.

“Although more people have been able to manage their blood pressure over the last few years, we’re not seeing this improvement translate into fewer hospitalizations for hypertensive crisis,” first author of the study and cardiologist Joseph E. Ebinger, MD, said in a press release.

There are several potential explanations for this increase in hospitalizations due to hypertensive crisis, according to the study authors. An increasing number of patients may be unable to afford medications to control their blood pressure, or they may see increases in blood pressure after taking inadequate doses of their medications.

Socioeconomic factors could also make it more difficult to individuals to avoid factors such as a high-salt diet, inactivity, smoking, or other unhealthy behaviors. Other socioeconomic factors could include limited access to health care, financial insecurity, or work and family demands.

“We need more research to understand why this is happening and how clinicians can help patients stay out of the hospital,” Ebinger said in the press release.

In the study, researchers analyzed data from the National Inpatient Sample, including a subset of all hospitalizations across the United States. They found that annual hospitalizations for hypertensive crises more than doubled over a 13-year period.

Hospitalizations related to hypertensive crises represented 0.17% of all admissions for men in 2002, compared to 0.39% of hospitalizations for men in 2014. Furthermore, hospitalizations related to hypertensive crisis represented 0.16% of all admissions for women in 2002 and 0.34% in 2014.

Based on their findings, the researchers estimated that from 2002 to 2014, there were 918,392 hospitalizations and 4377 in-hospital deaths related to hypertensive crisis in the United States.

“These findings raise the question: are there sex-specific biologic mechanisms that place women at greater risk for dying during a hypertensive crisis?” senior author Susan Cheng, MD, MPH, said in the press release. “By understanding these processes, we could prevent more deaths among women.”

REFERENCE

Uncontrolled blood pressure is sending more people to the hospital. News release. Cedars-Sinai Medical Center; January 27, 2022. Accessed January 27, 2022. https://www.cedars-sinai.org/newsroom/uncontrolled-blood-pressure-is-sending-more-people-to-the-hospital/