Hypertension Among Top Diagnoses For Cardiovascular Emergencies

Researchers identified that approximately one-third of cardiovascular disease (CVD) emergencies are due to poorly controlled high blood pressure or related conditions and significant disparities exist between men and women among CVD-related outcomes, according to a recent study.

Using data from the Nationwide Emergency Department Sample between 2016 and 2018, the researchers analyzed more than 20.6 million CVD emergency presentations, grouping them into 15 disease state categories. The sample was divided into men (n = 51.3%) and women (n = 48.7%), with an average age of 67 for the entire cohort.

The most common reasons for a CVD-related emergency department (ED) visit among women were essential hypertension (16.0%), hypertensive heart or kidney disease (14.1%), and atrial fibrillation/flutter (10.2%). For men, the most common were hypertensive heart or kidney disease (14.7%), essential hypertension (10.8%), and acute myocardial infarction (10.7%). Overall, approximately 30% of the total sample visited the ED due to a hypertension-related diagnosis.

Women were more likely than men to present with essential hypertension, hypertensive crisis, atrial fibrillation/flutter, supraventricular tachycardia, pulmonary embolism, or ischemic stroke. Acute myocardial infarction and cardiac arrest were more likely in men.

Additionally, men had a greater overall baseline comorbidity burden. Women had higher rates of obesity, hypertension, and cerebrovascular disease when compared with men.

Furthermore, women presenting to an ED with pulmonary embolism or deep vein thrombosis were less likely to be hospitalized and women who presented with aortic aneurysm/dissection or intracranial hemorrhage had higher odds of hospitalization and death. In contrast, men were more likely to die following presentations with hypertensive heart or kidney disease, atrial fibrillation/flutter, acute myocardial infarction, or cardiac arrest.

“Our findings highlight differences in health care needs of men and women, which may be used to inform service planning and provision,” the researcher concluded. “In addition, our work encourages further research to understanding the underlying factors driving differential CVD patterns and outcomes in men and women.”

—Jessica Ganga

Reference:

Raisi-Estabragh Z, Kobo O, Elbadawi A, et al. Differential patterns and outcomes of 20.6 million cardiovascular emergency department encounters for men and women in the United States. J Am Heart Assoc. Published online September 8, 2022. doi:10.1161/JAHA.122.026432