Hypertensive Emergency - Epidemiology

Epidemiology

Although an estimated 50 million or more adult Americans suffer from hypertension, the relative incidence of hypertensive crisis is relatively low (less than 1% annually). Nevertheless, this condition does affect upward of 500,000 Americans each year, and is therefore a not insignificant cause of serious morbidity in the US.

According to a research published in 2006, hypertension prevalence is again on the rise, with 28.6% of the U.S. population estimated to be suffering from it in the period 1999-2002. According to the study, relative incidence rates of hypertension range between 3% and 18% of the population. These numbers depend on the age, gender, ethnicity, and body size.

According to Whelton, the incidence and prevalence of hypertension is about 50% higher in African-American adults than in white or Mexican-American populations. Also, Whelton adds that prevalence of hypertension has increased progressively in children and adolescents between 1988-2000. According to this study, recent estimates indicate that approximately 1 billion adults worldwide have hypertension, with the highest prevalence of hypertension in Eastern Europe and the Latin American/Caribbean region.

As a result of the use of antihypertensives, the incidence of hypertensive emergencies has declined from 7% to 1% of patients with hypertension. The 1–year survival rate has also increased. Before 1950, this survival rate was only 20%, but it is now more than 90% with proper medical treatment.

Hypertensive crises more commonly occur among African-Americans and the elderly. Most patients who experience hypertensive crises have previously been diagnosed as hypertensive and been prescribed antihypertensive therapy, but continue to have inadequate blood pressure control.

Estimates indicate that approximately 1% to 2% of patients with hypertension develop hypertensive crisis at some point in their lifetime. Men are more commonly affected by hypertensive crises than women.

The incidence of hypertensive crises has increased and hospital admissions tripled between 1983 and 1990, from 23,000 to 73,000 per year in the United States. The incidence of postoperative hypertensive crisis varies and such variation depends on the population examined. Most studies report and incidence of between 4% to 35%.