Sociodemographic Predictors of Hypertensive Crisis in the Hospitalized Population in the United States.

Introduction : Hypertensive crisis (HC) encompasses hypertensive emergencies (HE) and urgencies (HU). Recent literature on HC's social determinants (SD) and racial disparities (RD) of the inpatient population is scarce. We aimed to examine these factors. Methods : A retrospective analysis of the 2016-2020 National Inpatient Sample was conducted, and all hospitalizations for HC were identified with their ICD-10 codes. A probability estimation of outcomes was calculated by performing multivariable logistic regression analysis, which took confounders into account. Our primary outcomes were SDs of HC. Secondary outcomes were myocardial infarction (MI), stroke, acute kidney injury (AKI), and transient ischemic attack (TIA). Results The minority populations were more likely than the Caucasians to be diagnosed with HCs: Blacks 2.7 (2.6-2.9), Hispanics 1.2 (1.2-1.3), and Asians 1.4 (1.3-1.5),(p<0.0001, all). Furthermore, being male 1.1 (1.09-1.2, p<0.0001), those with ‘self-pay’ insurance 1.02 (1.01-1.03, p<0.0001), and those in the <25th percentile of median household income 1.3 (1.2-1.3, p<0.0001), were more likely to be diagnosed with HCs. The Black population had the highest likelihood of end-organ damage: MI 2.7 (2.6-2.9), Stroke 3.2 (3.1-3.4), AKI 2.4 (2.2-2.5), and TIA 2.8 (2.7-3.0), (p<0.0001, all), compared to their Caucasian counterpart. Conclusions : Being of a minority population, male sex, low-income status, and uninsured were associated with a higher likelihood of hypertensive crisis. Blacks were the youngest and had the highest risk of end-organ damage. Targeted interventions and healthcare policies should be implemented to address these disparities and enhance patient outcomes.