Abstract P066: Short-term Outcomes Of Hypertensive Crises In Patients With Orthostatic Hypotension.

Abstract

Introduction: Current recommendations in management of supine hypertension-orthostatic hypotension disease (SH-OH) are mainly derived from outpatient studies with the aim of controlling SH while minimizing OH symptoms rather than targeting a specific standing blood pressure value. Data on short term outcomes of patients with OH who are hospitalized with hypertensive (HTN) crises is lacking. Methods: The Nationwide Readmission Database 2016-2019 was queried for all hospitalizations of HTN crises. Hospitalizations were stratified according to whether OH was present or not. We employed propensity score to match hospitalizations for patients with OH to those without, at 1:1 ratio. Outcomes evaluated were 30-days readmission with HTN crises or falls, as well as hospital outcomes of in-hospital mortality, acute kidney injury (AKI), acute congestive heart failure (CHF), acute coronary syndrome (ACS), type 2 myocardial infarction (T2MI), aortic dissection, stroke, length of stay (LOS), discharge to nursing home and hospitalization costs. Results: We included a total of 9,451 hospitalization (4,735 in the OH group vs 4,716 in the control group). OH group was more likely to be readmitted with falls (Odds ratio [OR]:3.27, p<0.01) but not with HTN crises(p=0.05). Both groups had similar likelihood of developing AKI (p=0.08), stroke/TIA (p=p=0.52), and aortic dissection(p=0.66). Alternatively, OH group were less likely to develop acute CHF (OR:0.54, p<0.01) or ACS (OR:0.39,p<0.01) in the setting of HTN crises than non-OH group. OH group were more likely to have longer LOS and have higher hospitalization costs. Conclusion: Patients with OH who are admitted with HTN crises tend to have similar or lower HTN-related complications to non-OH group while having higher likelihood of readmission with falls, LOS and hospitalization costs. Further randomized studies are needed to confirm such findings