Abstract 10060: Racial Differences in Outcomes of Hypertensive Crisis in Women With History of Preeclampsia: A National Sample Study

Abstract

Objective: Preeclampsia has been shown to put women at an increased risk of developing hypertension later in life. We aimed to determine racial differences in in-hospital outcomes of hypertensive crisis in women with history of preeclampsia in the United States. Methods: The national inpatient sample was retrospectively studied from 2012-2019 to identify hospitalizations for hypertensive crisis aged >18. We further identified history of preeclampsia within each admission using ICD-10 codes. The primary outcome was hospital length of stay (LOS) and inpatient mortality rate. Secondary outcomes were chosen as a 3-point composite development of stroke, myocardial infarction (MI) or congestive heart failure (CHF). Demographic (age, sex, race) information was also recorded. Caucasian patients were chosen as baseline reference to compare other ethnicities with. Data was analyzed with STATA 16.0, and adjusted odds ratios (AOR) were calculated using multivariate logistic regression. Results: There were 531,432 hospitalizations for hypertensive crisis, out of which 11% (58,457) had history of preeclampsia. 65% of this subset was Caucasian, 21% were African American (AA) and 11% Hispanic. Inpatient mortality rate was higher in Hispanic patients with preeclampsia vs Caucasians [6.2% vs 4.3%; AOR: 1.56 (1.49 – 1.61, p<0.001)]. AA patients had a longer LOS vs Caucasians [5.5 vs 3.2; AOR: 1.21 (1.19 – 1.25, p<0.001)]. There was no significant difference in LOS in Hispanic patients (p=0.08). Hispanic women had increased odds of developing stroke while inpatient compared to their Caucasian counterparts (AOR: 2.31, p<0.001). There was no significant difference in development of MI amongst the races (p=0.09). However, AA women with history of preeclampsia were more likely to develop CHF compared to Caucasians (AOR: 1.92, p<0.001). Conclusion: Hispanic women with history of preeclampsia have higher mortality rate and incidence of stroke when admitted with hypertensive crisis. Similarly, African American women with preeclampsia have longer hospital stay when admitted with hypertensive crisis. Further research is needed to understand and alleviate these cardiovascular burdens in ethnic minorities.