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Observational Study
. 2015 Dec 1;116(11):1717-23.
doi: 10.1016/j.amjcard.2015.09.007. Epub 2015 Sep 10.

Incidence of Hypertension-Related Emergency Department Visits in the United States, 2006 to 2012

Candace D McNaughton  1 , Wesley H Self  2 , Yuwei Zhu  3 , Alexander T Janke  4 , Alan B Storrow  2 , Phillip Levy  5
Affiliations
Observational Study

Incidence of Hypertension-Related Emergency Department Visits in the United States, 2006 to 2012

Candace D McNaughton et al. Am J Cardiol. .

Abstract

Hypertension is a common chronic condition, but the burden of emergency department (ED) visits due to hypertension and associated patient and hospital characteristics are not well described. The goals of this study were to (1) establish the burden of hypertension-related ED visits, estimated by the total number, proportion of adult visits, and population-based rate, (2) evaluate for change over time, and (3) identify associated patient and hospital characteristics. The Nationwide Emergency Department Sample from 2006 to 2012 was used to identify hypertension-related ED visits (International Classification of Diseases, Ninth Revision, Clinical Modification codes 401 to 405, inclusive, and 437.2), and this was linked to US Census Bureau July population estimates to determine population-based rates for each study year. Negative binomial regression was performed to determine whether rates of hypertension-related ED visits changed over time. A total of 165,946,807 hypertension-related ED visits occurred during the 7-year study period (23.6% of all adult ED visits), and hypertension was the primary diagnosis for 6,399,088 (0.9% of all adult ED visits). The estimated yearly incidence rate increased 5.2% per year (incident rate ratio, 1.052; 95% confidence interval, 1.044 to 1.061; p <0.001) for hypertension-related visits and 4.4% per year (incidence rate ratio, 1.044; 95% confidence interval, 1.038 to 1.051; p <0.001) for ED visits with a primary diagnosis of hypertension. Over the same time, the proportion hospitalized decreased and the proportion of visits increased at safety net hospitals and among uninsured patients. In conclusion, these data indicate that hypertension-related ED visits are common and increasing.

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Conflict of interest statement

Conflict(s) of Interest/Disclosure(s): The authors have no relevant conflicts of interest to disclose.

Figures

Figure 1
Figure 1. Annual Incidence of Hypertension-Related Emergency Department Visits and Emergency Department Visits With a Primary Diagnosis of Hypertension, 2006–2012
Left Y-axis, dashed line: Rate of Hypertension-Related ED Visits (per 1,000 Adult Population Per Year); bars, 95% Confidence Intervals Right Y-axis, solid line: Rate of ED Visits with Primary Diagnosis of Hypertension (per 1,000 Adult Population Per Year); bars, 95% Confidence Intervals Abbreviations: ED, emergency department
Figure 2
Figure 2. Annual Incidence of Hypertension-Related Emergency Department Visits By Age Group, 2006–2012
All Rates of Hypertension-Related ED Visits are Per 1,000 Adult Population Per Year) Dotted Line: Age 19–44 Years Dashed Line: Age 45–64 Years Solid Line: Age 65–79 Years Dot-Dashed Line: Age 80 and Greater Years Bars, 95% Confidence Intervals Abbreviations: ED, emergency department
Figure 3
Figure 3. Annual Incidence of Hypertension-Related Emergency Department Visits By Geographic Region, 2006–2012
All Rates of Hypertension-Related ED Visits are Per 1,000 Adult Population Per Year) Dot-Dashed Line: West Solid Line: Northeast Dashed Line: Midwest Dotted Line: South Bars, 95% Confidence Intervals Abbreviations: ED, emergency department
Figure 4
Figure 4. Seasonal Variation: Monthly Incidence of Hypertension-Related Emergency Department Visits, 2006–2012
Solid Line: Hypertension-Related ED Visits (Per 1,000 Adult Population Per Year) Gray Shading: Winter (October 1 through last day of February of the following year) Abbreviations: ED, emergency department
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