Male sex was independently associated with increased hypertension-mediated organ damage and poorer BP control at 72 hours, despite men presenting at a younger age (56.8 vs 62.4 years, p=0.002).
Observational (n=257)
Yes
Does male sex associate with worse blood pressure control and higher rates of hypertension-mediated organ damage compared to female sex in patients presenting with hypertensive urgency?
In patients presenting with hypertensive urgency, men exhibit poorer blood pressure control and a higher prevalence of hypertension-mediated organ damage at 72 hours compared to women.
Acute blood pressure disorders are a common yet heterogeneous clinical challenge in the Emergency Department (ED), often requiring rapid assessment and risk stratification. Among these, Hypertensive Urgency (HU) is a frequent presentation, characterized by severely elevated blood pressure (BP) without acute hypertension-mediated organ damage (HMOD). Despite its clinical relevance, sex-related differences in HU remain poorly understood. . This study aimed to investigate sex differences in clinical presentation, BP control and HMOD prevalence in subjects presenting with HU. Methods. A multicentric prospective study was conducted, enrolling symptomatic patients with HU, admitted to six Italian EDs. They were assessed within 72 h after ED discharge to evaluate BP control and to detect subclinical HMOD.. A total of 257 patients were enrolled, including 134 females (52%). The mean age was 59.7 ± 14 years, with women being significantly older than men (62.4 ± 15 vs. 56.8 ± 13, p value = 0.002). Men were more frequently active smokers and had a higher rate of diabetes and obesity. They also had higher diastolic BP, at both ED admission and discharge, and higher systo-diastolic BP at the 72-h visit. Male sex was independently associated with increased rate of HMOD—regardless of the specific organ involved—and with poor BP control at 72 h from ED discharge. . Compared to women, men with HU exhibited higher BP levels and poorer BP control at 72 h. They also showed a higher prevalence and greater severity of HMOD. Male sex emerged as independently associated with HMOD. Graphical Abstract Two hundred fifty-seven individuals presented to Emergency Department (ED) with a Hypertensive Urgency. The figure summarizes the main findings of the study. Men were younger, but with a higher rate of diabetes, obesity, and active smoking. Furthermore, men had a higher diastolic blood pressure (DBP) at ED presentation and discharge, as well as at 72 h Hypertension Center reassessment. Men had a lower rate of BP control at 72 h, as well as a higher rate of cardiac HMOD. Male sex was an independent predictor of overall HMOD, as well as of cardiac and renal organ damage when considered individually. In the figure: BP, blood pressure; DBP, diastolic blood pressure; ED, Emergency Department; HMOD, Hypertension mediated organ damage; SBP, systolic blood pressure.
Fanelli et al. (Thu,) conducted a observational in Hypertensive Urgency (n=257). Male sex vs. Female sex was evaluated on Hypertension-mediated organ damage (HMOD) and blood pressure control. Male sex was independently associated with increased hypertension-mediated organ damage and poorer BP control at 72 hours, despite men presenting at a younger age (56.8 vs 62.4 years, p=0.002).