Hypertensive emergency: Case criteria, sociodemographic profile, and previous care of 100 cases

To study the frequency, cost, sociodemographic profile, and previous care correlates of hospital admissions for hypertensive emergency, we used specific case criteria to identify a series of 100 cases at Presbyterian Hospital in New York City. Approximately 58 cases were admitted per year. Mean length of hospital stay was 11.8 days, 75 per cent of patients received intensive care, and estimated annual hospital charges were $438,828 (1986 dollars). Cases had severe hypertension on admission (mean systolic blood pressure, 229.8 mmHg; mean diastolic blood pressure, 143 mmHg). Two-thirds had clinical evidence of acute arteriolitis. Cases were predominantly young, male, Black of Hispanic, and of lower socioeconomic status. At least 93 per cent of cases were previously diagnosed, and at least 83 per cent were aware of their diagnosis of hypertension. Improved management of chronic hypertension rather than more intensive screening may be a useful strategy to reduce the incidence of hypertensive emergency.