Abstract 994: African Americans Hospitalized With Acute, Severe Hypertension Receive Less Intense Treatment and Follow-up Than Peers: Results From the STAT Registry
Background: While AAs are more likely than whites to have HTN, it is unknown whether care or outcomes of hospitalized patients with acute, severe HTN differs by race.
Methods: We studied 1078 pts enrolled in Studying the Treatment of Acute hyperTension (STAT), a multicenter registry of patients with acute, severe HTN treated with IV antihypertensives. Logistic regression models were constructed to evaluate the effect of race on clinical end-points after adjustment for baseline differences.
Results: 748 (69%) patients were AA. AAs were more likely to be younger (54 vs. 62y), uninsured (17 vs. 5%), have hx of HTN or previous hospitalization for acute, severe HTN (42 vs. 15%), hx of CHF (32 vs. 15%), and drug abuse (23 vs. 7%) (p<0.0001 for all). Physicians were more likely to classify the predisposing factor for hospitalization as “med non-adherence” in AAs (35 vs. 18%, p<0.001). AAs were less likely to be admitted to an ICU (37 vs. 44%, p=0.020) or have invasive BP monitoring (11 vs. 26%, p<0.0001). Initial SBP and DBP were higher in AAs, time to initiate IV therapy was longer, and time to achieve a 10% drop in SBP was greater (p<0.05 for all). LOS was shorter among AAs (3 vs. 5d, p<0.0001). AAs had higher SBP (150 vs. 145mmHg, p=0.002) and DBP (82 vs. 73mmHg, p<0.0001) at discharge, and also had less scheduled outpatient follow-up (27 vs. 40%, p<0.0001). After adjustment, 90 day mortality was similar, but there was a trend towards greater 90-day readmission rates among AAs (Fig⇓).
Conclusion: There appear to be significant racial differences in the care of patients hospitalized with acute, severe HTN, suggesting the need for future monitoring and quality improvement for this understudied condition.