Abstract
Current evidence on the prognosis of patients with a hypertensive crisis and predisposing factors is limited. We registered the clinical phenotype of patients with HC admitted to the emergency department, while those with a hypertensive emergency (HE) were hospitalized. One-year outcomes, i.e., composite of death or cardiovascular hospitalizations, were determined in patients with HE after hospital discharge. Out of 38,589 patients assessed in the emergency department, 256 hypertensive urgencies and 97 HE was registered. After stratification of the HE by sex, 48 men and 46 women completed the one-year follow-up. Men had more events than women (27 vs. 13, Ηazard Ratio 2.2, 95% Confidence Interval 1.03-4.7, p = 0.042) after adjustment for age, cardiovascular or chronic kidney disease, and diabetes mellitus. Our study raises the hypothesis that the male sex is an independent risk factor for cardiovascular outcomes in HE patients.
CV Cardiovascular, BP blood pressure. The diagram presents the groups of comparison, men versus women in hypertensive emergencies that completed the 1-year follow-up for outcomes, in terms of hospitalizations or deaths.
This is a preview of subscription content, access via your institution
Access options
Subscribe to this journal
Receive 12 print issues and online access
$259.00 per year
only $21.58 per issue
Buy this article
- Purchase on Springer Link
- Instant access to full article PDF
Prices may be subject to local taxes which are calculated during checkout
References
Williams B, Mancia G, Spiering W, Agabiti Rosei E, Azizi M, Burnier M, et al. 2018 ESC/ESH Guidelines for the management of arterial hypertension. Eur Heart J. 2018;39:3021–104.
Whelton PK, Carey RM, Aronow WS, Casey DE Jr, Collins KJ, Dennison Himmelfarb C, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Soc Hypertens. 2018;12:579.e1–579.e73.
van den Born BH, Lip GYH, Brguljan-Hitij J, Cremer A, Segura J, Morales E, et al. ESC Council on hypertension position document on the management of hypertensive emergencies. Eur Heart J Cardiovasc Pharmacother. 2019;5:37–46.
Peixoto AJ. Acute severe hypertension. N. Engl J Med. 2019;381:1843–52.
Saguner AM, Dür S, Perrig M, Schiemann U, Stuck AE, Bürgi U, et al. Risk factors promoting hypertensive crises: evidence from a longitudinal study. Am J Hypertens. 2010;23:775–80.
Webster J, Petrie JC, Jeffers TA, Lovell HG. Accelerated hypertension—patterns of mortality and clinical factors affecting outcome in treated patients. QJM: Int J Med. 1993;86:485–99.
Szczech LA, Granger CB, Dasta JF, Amin A, Peacock WF, McCullough PA, et al. Acute kidney injury and cardiovascular outcomes in acute severe hypertension. Circulation. 2010;121:2183–91.
Paini A, Tarozzi L, Bertacchini F, Aggiusti C, Rosei CA, De Ciuceis C, et al. Cardiovascular prognosis in patients admitted to an emergency department with hypertensive emergencies and urgencies. J Hypertension. 2021;39:2514–20.
Fragoulis C, Dimitriadis K, Siafi E, Iliakis P, Kasiakogias A, Kalos T, et al. Profile and management of hypertensive urgencies and emergencies in the emergency cardiology department of a tertiary hospital: a 12-month registry. Eur J Preventive Cardiol. 2022;29:194–201.
Astarita A, Covella M, Vallelonga F, Cesareo M, Totaro S, Ventre L, et al. Hypertensive emergencies and urgencies in emergency departments: a systematic review and meta-analysis. J Hypertens. 2020;38:1203–10.
Raisi-Estabragh Z, Kobo O, Elbadawi A, Velagapudi P, Sharma G, Bullock-Palmer RP, 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. 2022;11:e026432.
Deshmukh A, Kumar G, Kumar N, Nanchal R, Gobal F, Sakhuja A, et al. Effect of Joint National Committee VII report on hospitalizations for hypertensive emergencies in the United States. Am J Cardiol. 2011;108:1277–82.
Kumar N, Simek S, Garg N, Vaduganathan M, Kaiksow F, Stein JH, et al. Thirty-day readmissions after hospitalization for hypertensive emergency. Hypertension. 2019;73:60–7.
Kim BS, Kim H-J, Shin J-H, Lee JH, Kim W, Park JK, et al. Sex differences in long-term mortality of patients with hypertensive crisis visiting the emergency department. J Women’s Health (Larchmt). 2022;31:1137–44. https://doi.org/10.1089/jwh.2021.0430. Epub 2021 Dec 2.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
The authors declare no competing interests.
Additional information
Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Fragoulis, C., Polyzos, D., Dimitriadis, K. et al. Sex-related cardiovascular prognosis in patients with hypertensive emergencies: a 12-month study. Hypertens Res 46, 756–761 (2023). https://doi.org/10.1038/s41440-022-01129-2
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1038/s41440-022-01129-2
