Objective: Hypertensive crisis (HC) disproportionately affects certain racial groups due to healthcare disparities. While racial inequities in hypertension management are well-documented, hospitalization trends in the COVID-19 era remain underexplored. Methods: The NIS dataset (2020-2022) was used. 72,652 adult HC hospitalisations without active or past COVID-19 infection, were identified using ICD-10 codes. Patients were categorized by ethnicity into White (n=35,632), Black (n=27,671), and Hispanic (n=9,349) (Figure 1A). Standard statistical tests were employed, and multivariate logistic regression identified predictors of in-hospital mortality. Results: Whites comprised nearly 50% of HC hospitalizations, while Hispanics accounted for 13%. Blacks (38%, p<0.05) were the youngest hospitalized cohort (Figure 1B), facing the greatest socioeconomic disadvantage, with over 50% residing in the lowest-income areas (<50,000USD/ year). Hospitalizations increased in Hispanics (+1.9%), Remained the same in Blacks and decreased in Whites (-2.1%) (Figure 1B). Insurance disparities were notable, with private/self-pay required for 25% of Whites versus over 40% of other groups. Blacks exhibited the highest comorbidity burden (93% with ≥2 conditions), including congestive heart failure (38%) and elevated smoking rates (43%). Despite better in-hospital outcomes, Whites had higher rates of discharge requiring specialized care (26% vs. <20% for others). Black and Hispanic patients faced greater financial burdens. RACE was not an independent predictor of mortality, which was influenced by clinical factors (Figure 1C). Conclusions: HC disproportionately affects younger Blacks, while rising hospitalizations among Hispanics highlight growing disparities. Insurance and financial burdens exacerbate these issues, and mortality was driven by clinical factors rather than race. These findings support AHA objectives, emphasizing the need for targeted interventions to advance health equity in hypertension management.
Peela et al. (Mon,) studied this question.