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Morbidity from hypertension more prevalent in black individuals

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Frederick A. Waldron

When not properly controlled, hypertension can lead to hypertensive crisis and end-organ damage, and the condition is more common in inner-city black individuals than in the general population, according to findings presented at the American Heart Association’s Joint Hypertension Scientific Sessions.

“Hypertensive crisis is five times more prevalent in this African-American community compared to the national average,” Frederick A. Waldron, MD, emergency medicine physician at Newark Beth Israel Medical Center in Newark, New Jersey, told Cardiology Today. “Approximately one-fourth of them have end-organ damage.”

Researchers investigated the frequency of and risk factors for hypertensive emergency and hypertensive urgency in an inner-city population by conducting a 3-year retrospective case-control study of 1,784 adults who had visited the ED with a BP of at least 200 mm Hg systolic/120 mm Hg diastolic. The control group had hypertension as defined by BP between 140 mm Hg systolic/90 mm Hg diastolic and 200 mm Hg systolic/120 mm Hg diastolic. Controls were matched 1:1 for age, sex and race. In total, 15,631 participants had hypertension (89% black; 2% white).

Researchers found that the prevalence of hypertensive crisis was 11.4% and the prevalence of hypertensive emergency was 3.2%. End-organ damage occurred in 28% of the cases, which had increased odds of acute kidney injury (OR = 1.54; P = .022), acute or worsening congestive HF (OR = 4.91; P < .0001), non-STEMI (OR = 2.39; P < .0001), ischemic stroke (OR = 3.27; P < .0001) and hemorrhagic stroke (OR = 4.55; P < .001).

Risk factors for hypertensive crisis included being older than 65 years, being male, and having anemia, chronic kidney disease, stroke or CVD comorbidities such as hyperlipidemia, CAD and congestive HF.

Researchers noted that insurance status and access to primary care were not associated with an increased odds of end-organ damage.

“Being African-American is not a risk factor for developing end-organ damage, [and hypertensive crisis] may be prevented by adherence to hypertensive medication,” Waldron said. – by Melissa J. Webb

Reference:

Waldron FA, et al. Abstract P297. Presented at: The American Heart Association’s Joint Hypertension Scientific Sessions; Sept. 6-9, 2018; Chicago.

Disclosures: The authors report no relevant financial disclosures.