Abstract P405: Outcomes And Trends Of Hypertensive Crisis In Patients Aged 40 Years Or Younger: Results From National Inpatient Sample 2016-2020

Abstract

Introduction: Hypertension is the leading modifiable risk factor of cardiovascular morbidity and mortality. The trends of hypertension and its complications in young individuals are not well studied. Methods: We examined hospitalized patients who were diagnosed with hypertensive crisis and were included in the National Inpatient Sample 2016-2020. Hypertensive crisis was defined by using international classification of disease -10. Patient aged less than 18 years and pregnant women were excluded. Multivariable logistic regression analysis was used to examine association of age 40 years or less and hypertensive crisis with primary outcome of mortality, and secondary outcomes. We also studied trends of hypertensive crisis in these patients. Results: There were 589,220 (mean age 61years±17, 55.7% female, 45% white) patients with hypertensive crisis. Out of these, 12.3% (n= 72,200) were aged less than 40 years. In the group of patients with age 40 years or younger, 0.13% (n= 90) died. The major secondary outcomes in this group were acute kidney injury (26%) with 15.4% requiring hemodialysis, acute heart failure (17.8%), and hypertensive encephalopathy (3.28%). The outcomes of hypertensive crisis in younger patients are shown in figure 1 . From 2016-2020, there are decreasing yearly trends of hypertensive crisis in these patients (p= 0.004) and no statistically significant trends in mortality (p =0.2)!. Conclusion: Hypertensive crisis brings morbidity and economic burden on the patients. A considerable number of young patients develop acute kidney injury and require hemodialysis. More studies directed towards young patients are needed to prevent these complications.