Prevalence and risk factors for hypertensive crisis in a predominantly African American inner-city community

Abstract

Purpose: A 3-year case control study was conducted to determine the prevalence of hypertensive crisis and its subtypes, hypertensive emergency and hypertensive urgency. The secondary objectives were to identify risk factors for hypertensive emergencies and to determine the odds of developing acute target organ damage among predominantly African American patients with a confirmed diagnosis of hypertension. Materials and methods: Using emergency department medical records, patients with a confirmed diagnosis of hypertension were identified. From the pool of hypertensive patients, cases and controls were selected and matched 1:1 for age, gender and race. Cases were hypertensive patients with hypertensive crisis, defined as BP ≥ 200/120 mmHg. Controls had a diagnosis of hypertension and BP < 200/120 mmHg. Cases and controls, as well as cases with hypertensive emergencies and hypertensive urgencies were compared based on important demographic and clinical variables. Results: Almost 90% of study population were African Americans. The prevalence of hypertensive crisis was 11.4% and hypertensive emergencies was 3.2%. Hypertensive emergencies accounted for 28% of patients with crisis. The predictors for hypertensive emergencies were older age (p =.002), male gender (p