Abstract
Introduction: With the increasing use of recreational cannabis in the youth and earlier reports suggesting its potential association with systolic hypertension, we planned to assess the burden with disparities, predictors and outcomes of hypertensive (HTN) crisis in young cannabis users vs. non-users. Methods: We queried the National Inpatient Sample (October2015-2017) to identify admissions among young (18-44 years) cannabis users with HTN crisis. Rates of HTN crisis admissions with racial/sex disparities were assessed in cannabis users vs. non-users. Multivariable analysis was performed adjusting for covariates to assess the predictors of HTN crisis in cannabis users and odds of inpatient mortality. Results: Of 623,715 admissions among young cannabis users, 4675 (0.7%) had HTN crisis. Among cannabis users, non-whites and females were more often admitted for HTN crisis cohort compared to non-users (Figure 1). Among young cannabis users, males (OR 1.12, CI 1.04-1.19), blacks (OR 3.28, CI 3.02-3.56), patients admitted non-electively (OR 3.09, CI 2.53-3.76) with comorbidities like chronic kidney disease (OR 8.83, CI 8.14-9.59), congestive heart failure (OR 3.35, CI 2.13-3.08), obesity (OR 2.83, CI 2.62-3.05), valvular diseases (OR 2.56, CI 2.13-3.08), fluid and electrolytes disorders (OR 2.25, CI 2.11-2.40), diabetes mellitus (OR 1.82, CI 1.67-1.97) and hyperlipidemia (OR 1.71, CI 1.56-1.87) predicted higher odds of HTN crisis (p<0.001). Interestingly, cannabis users admitted for HTN crisis had lower odds of in-hospital mortality (OR 0.67, CI 0.45-0.99, p<0.05) compared to non-users when adjusted for confounders. Conclusions: Non-white and male cannabis users had higher odds of HTN-crisis admissions. Cannabis users with preexisting cardiovascular and metabolic comorbidities had higher odds of developing HTN crisis. Lower risk of inpatient mortality following HTN-crisis in cannabis users warrants future prospective studies.
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