Abstract Body: Background: Females have steeper increases in blood pressure than males throughout life, thus setting the stage for gender based phenotypic and clinical differences in hypertension related pathologies. We set out to determine the in-hospital mortality for the patients primarily admitted for Hypertensive Heart Disease (HHD) in the United States.
Methods: Data was extracted from the National Inpatient Sample (NIS) 2016 - 2020 Database. We used ICD-10 code I11.9 to identify the patients primarily admitted for HHD. Multivariable Logistic regression was used to estimate Odds Ratio (OR) for in-hospital mortality between the two genders. Multivariable Poisson regression model was performed for yearly trends with year as the independent variable and in-hospital mortality as the dependent variable. In-hospital mortality rate trends between the two genders were compared using a group-year interaction term in a multivariable regression analysis with in-hospital mortality event as the dependent variable. All the outcomes were adjusted for age, insurance status, race, Charlson comorbidity index (CCI) and the hospital characteristics (location, bed-size). The analysis was performed on STATA 16 software.
Results: We identified 1,877,150 patients with HHD. Mean age of the patient cohort was 70 years, mean CCI was 2.7 and 51% were females. Unadjusted in-hospital mortality rate for males was 1.6% compared to 1.8% for females. When adjusted for cofounders, females had lower risk of in-hospital mortality compared to males (OR: 0.95, 95% CI 0.90 – 0.99). In-hospital mortality rate for either gender did not appreciably change from 2016 – 2020, however, when compared to males the mortality rate for females rose more sharply (Interaction p = 0.038) as shown in Figure 1.
Conclusion: In our adjusted population-based survey analysis, short term mortality risk for HHD was lower for females than males, however, during the study period 2016 – 2020 mortality rate for females rose more sharply than for male subjects.