More people hospitalized for hypertensive emergency in last decade in U.S.

A new study shows an increase in hospitalizations in the United States due to hypertensive emergencies but fewer deaths. Photo by Photographee.eu/Shutterstock

April 21 (UPI) — A new study shows an increase in hospitalization for hypertensive emergency while at the same time revealing a reduction in deaths from hypertension over the last 10 years.

Hypertension, or high blood pressure, is a significant risk factor for cardiovascular disease with nearly one in three adults in the United States having hypertension with the highest rates among African-Americans.

Hypertension is the most common health problem in primary care settings and is the most important modifiable risk factor in the prevention of myocardial infarction, stroke and renal failure.

Hypertensive emergencies occur when severe high blood pressure leads to new or worsening target-organ injury such as heart failure, pulmonary edema, stroke, aortic dissection or cerebral dysfunction.

Conditions that can be predictive of higher hospital mortality include some of the same conditions caused by severe high blood pressure, including acute cardiorespiratory failure, stroke and aortic dissection.

“There is an increasing trend in patients being admitted for hypertensive emergency with overall reduction in hospital mortality, which is probably secondary to changes in coding practices and improvement in management over the years with growing experience,” Dr. Mahek Shah, of the Lehigh Valley Health Network, said in a press release.

Researchers analyzed data collected between 2002 and 2012 as part of a nationwide inpatient sample database, finding a total of 129,914 hospital admissions for hypertensive emergency and 630 patient deaths during their hospital stay.

From 2002 to 2012, there was a 63 percent increase in the number of hospital admissions, however, the rate of in-hospital deaths for hypertensive emergencies decreased from 0.8 percent per year in 2002 to 0.3 percent per year in 2012. Halfway through the study, in 2007, the number of deaths from hypertensive emergencies had decreased by about half.

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Researchers found that patients who died from a hypertensive emergency in the hospital were older, had longer hospital stays and other comorbidity risk factors. Patients who died during hospital stays for hypertensive emergency were more than seven times as likely to have acute cardiorespiratory failure compared to patients who survived. More than half of the patients who died had two or more end-organ complications.

“Considering the significance of disease among hypertensive patients, and the large economic burden it poses on the system, guidelines directing care and protocol may be beneficial,” Shah said. “We hope that our findings help physicians risk stratify patients with hypertensive emergency, identify those at significantly higher risk for worse outcomes and improve care among those patients.”

The study was published in the American Journal of Hypertension.

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