When it comes to why U.S. heart patients wind up in the emergency room, uncontrolled high blood pressure (or "hypertension") fuels about one-third of those medical crises.
“These visits resulted in hospital admission less than 3% of the time and with very few deaths — less than 0.1%. This suggests that these visits were mostly related to the management of hypertension,” said study author Dr. Mamas A. Mamas. He is a professor of cardiology at Keele University in Stoke-on-Trent and a consultant cardiologist at University Hospitals of North Midlands NHS Trust, both in the United Kingdom.
The study, published online recently in the Journal of the American Heart Association, included data on 15 cardiovascular conditions, whereas previous studies have been limited to visits for suspected heart attacks, Mamas said.
So the new study "helps to better understand the full spectrum of acute [heart disease] needs, including sex disparities in hospitalization and risk of death,” Mamas explained in a news release from the American Heart Association.
About 49% of the sample were women and the average age was 67. Most were covered by Medicare or Medicaid.
The researchers also found that men and women visited the emergency department for different heart-related reasons.
Women were less likely than men to die or to be admitted to the hospital — 3.3% of women died compared to 4.3% of men — after a cardiovascular emergency. Just over 49% of women were hospitalized, compared to about 52% of men.
The women in the study were more likely be obese, have high blood pressure and suffer from medical conditions that affect blood vessels in the brain. About 16% of women were seen for high blood pressure, nearly 15% for heart or kidney disease and 10% for atrial fibrillation (an irregular heart rhythm).
Men were more likely to have diabetes. Nearly 15% were seen for high blood pressure-related heart or kidney disease, just under 11% for high blood pressure and 11% for heart attack.
It's possible that the reason fewer women died or were hospitalized than men is their generally lower risk of diagnoses, but it could also be because of underestimating deaths in women.
“We did not track deaths outside of the hospital setting,” Mamas said. “Given past evidence that women are more likely to be inappropriately discharged from the emergency department, and strong evidence for the systemic undertreatment of women, further study is warranted to track outcomes beyond the emergency department visit.”
The U.S. Centers for Disease Control and Prevention has more on high blood pressure.
SOURCE: American Heart Association, news release, Sept. 20, 2022