The number of people hospitalised for a hypertensive crisis has more than doubled from 2002 to 2014, according to Cedars-Sinai investigators.
The increase occurred during a period when some studies reported overall progress in blood pressure control and a decline in related cardiovascular events in the U.S. The findings are 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 hospitalisations for hypertensive crisis,” said Joseph E. Ebinger, MD, a clinical cardiologist and director of clinical analytics at the Smidt Heart Institute and first author of the study.
Ebinger said there could be various explanations for why a growing number of people are being hospitalised for dangerously high blood pressure. It could be that an increasing number may be unable to afford medications to control hypertension or are seeing their blood pressure rise after taking inadequate doses of these drugs.
Socioeconomic factors may also make it difficult for people to avoid a high-salt diet, inactivity, smoking or other unhealthy behaviours that can contribute to hypertension. These factors may include limited access to healthcare, 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.
To conduct their study, the investigators analysed data from the National Inpatient Sample, a publicly available database. The data include a subset of all hospitalisations across the U.S., providing a picture of nationwide trends. They found that annual hospitalisations for hypertensive crises more than doubled over a 13-year period. Hospitalisations related to hypertensive crises represented 0.17% of all admissions for men in 2002 but 0.39% in 2014. Hospitalisations related to hypertensive crisis represented 0.16% of all admissions for women in 2002 but 0.34% in 2014.
The investigators estimated that from 2002 to 2014, there were 918,392 hospitalisations and 4,377 in-hospital deaths related to hypertensive crisis across the U.S. The risk of dying from a hypertensive crisis decreased slightly overall during the studied time period. Women died at the same rate as men, even though they had fewer health issues than men who also were hospitalised for a hypertensive crisis.
Source: Journal of the American Heart Association
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