Abstract 17986: Impact of Race and Socioeconomic Factors on Hypertensive Emergency

Abstract

Background: Hypertensive emergency, defined as a blood pressure ≥ 180/110mmHg with target organ damage, is a major cause of cardiovascular morbidity and mortality. There is a lack of data on the impact of race and socioeconomic factors on hypertensive emergency incidence and outcomes. Thus, we investigated these associations in a diverse population at a large tertiary-care academic medical center. Methods: Utilizing the Patient Cohort Explorer Epic electronic health records system at the University of Mississippi Medical Center from 1/1/2013 to 7/31/2021, we identified patients diagnosed with hypertensive emergency. Sociodemographic factors related to hypertension and patient status (alive/deceased) were also examined. Descriptive statistics were used to examine differences in means across groups. Results: 2,483 patients diagnosed with hypertensive emergency were included in this analysis. Among these patients, the mean (SD) age was 52 (17) years, 49% were women, and 82.2% were Black. Nearly half (44.4%) of those diagnosed with hypertensive emergency were uninsured, 46.7% had Medicaid or Medicare, and 7.9% had private insurance. Black patients with hypertensive emergency were significantly younger compared with White patients (51 vs 57 years, p<0.001). There was no significant correlation between race and insurance status in this population. Over the 8-year period, 14.1% were deceased at the time of analysis. Conclusions: Among patients admitted to a large academic medical center with hypertensive emergency, most were Black individuals with Medicaid or lacking health insurance. Black individuals present at significantly younger ages compared to White patients. Our findings are much different than data published from the Nationwide Readmissions Database reporting a mean age of 66 years and nearly 90% insured rate in patients with hypertensive emergency. Further, race was not reported in that analysis. Our findings suggest that hypertensive emergency disproportionately affects minority and underserved populations. Further work is needed to characterize risk factors and improve outcomes for this high-risk population.