Patients without prior hypertension had fewer ambulatory visits (M=31,945) than those with hypertension (M=34,958) following intracerebral hemorrhage.
Do demographic factors and follow-up visit patterns differ between patients with and without a prior hypertension diagnosis at the time of hypertensive intracerebral hemorrhage?
Patients presenting with hypertensive intracerebral hemorrhage without a prior hypertension diagnosis are younger and have fewer follow-up visits post-ICH compared to those with known hypertension.
Absolute Event Rate: 0% vs 0%
Introduction: Untreated hypertension (HTN) is a significant risk factor for intracerebral hemorrhage (ICH), leading to hematoma expansion and worse outcomes. Patients often go undiagnosed with HTN until presentation, and some continue to not treat it after ICH, increasing stroke risk. Our study compared demographic and clinical factors between individuals with and without pre-ICH HTN diagnoses, and follow-up visit patterns between these groups. Methods: We performed a retrospective study using a de-identified federated database with 104 healthcare organizations and over 150 million patients from the TriNetX Research Network. We grouped patients diagnosed with hypertensive, nontraumaic ICH (ICD-10: I61.0, I61.2, I61.3, I61.4, I61.8, or I61.9) based on their HTN status at the time of ICH. We used 1:1 greedy nearest-neighbor propensity score matching to balance cohorts based on age, sex, race, ethnicity, nicotine dependence, hyperlipidemia, Type 2 diabetes (T2DM), and obstructive sleep apnea. We compared continuous variables using t-tests and categorical variables using chi-squared tests or Fisher’s exact tests, as appropriate. We also compared the number of emergency and ambulatory visits within 1 year following the ICH for each cohort using independent t-tests. Results: We sampled 198,463 patients (n=58,560 with prior HTN, n=139,903 without prior HTN). Mean age for the ICH group without HTN was lower (48.9 ± 24.9yo) compared to those with HTN (67.5 ± 14.6yo); 53.7% and 52.1% of patients without HTN and with HTN diagnosis were male, respectively; and black people represented 11.3% of patients without HTN and 17.5% with HTN. After matching, individuals without prior HTN with ICH were more likely to be of black race, have nicotine dependence, and T2DM with neurological complications ( p < 0.01). One year post ICH, individuals with prior HTN had, on average, more ambulatory visits (M = 34,958) than those without prior HTN (M=31,945). Individuals with prior HTN had more ED visits (M=9,495) compared to those without HTN (M=6,521). Conclusion: Among those without a prior HTN diagnosis, a higher proportion were black. Nicotine dependence and T2DM with neurological manifestations are more common in this group, which may increase risk for hypertensive-related ICH. Patients without a prior HTN diagnosis have fewer follow-up visits after their ICH. This subgroup may represent individuals who didn’t previously follow a physician, though further studies are needed.
Schichtel et al. (Thu,) reported a other. Patients without prior hypertension had fewer ambulatory visits (M=31,945) than those with hypertension (M=34,958) following intracerebral hemorrhage.