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National Trends in Mortality and Urgent Dialysis after Acute Hypertension in Japan From 2010 Through 2019

Hisazumi Matsuki1, Taku Genma1, Shintaro Mandai1

  • 1Department of Nephrology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Bunkyo, Tokyo, Japan (H.M., T.G., S.M., T.F., Y.M., F.A., T.M., K.S., S.I., S.N., E.S., T.R., S.U.).

Hypertension (Dallas, Tex. : 1979)
|October 11, 2023
PubMed

Insights

Mortality and urgent dialysis rates following acute hypertension (AHT) have risen. Aging, complex health issues, and hypertensive heart failure (HHF) are key factors driving increased AHT mortality.

Area of Science:

  • Nephrology
  • Cardiology
  • Epidemiology

Background:

  • Acute hypertension (AHT) is increasingly prevalent.
  • Recent trends in AHT-related mortality and urgent dialysis are not well-defined.

Purpose of the Study:

  • To evaluate trends in incidence, mortality, and urgent dialysis among hospitalized AHT patients.
  • To identify risk factors associated with mortality and urgent dialysis in AHT.

Main Methods:

  • Retrospective observational cohort study of 50,316 hospitalized AHT patients (2010-2019) using Japanese administrative claims data.
  • AHT categorized into 5 spectrums: malignant hypertension, hypertensive emergency, hypertensive urgency, hypertensive encephalopathy, and hypertensive heart failure (HHF).
  • Poisson regression models used to examine trends and risk factors.

Main Results:

  • AHT incidence was 70 per 100,000 admissions.
  • Overall mortality rates increased from 1.83% to 2.88% (P<0.0001), particularly in older patients (≥80), those with low BMI, and HHF.
  • Urgent dialysis rates increased from 1.52% to 2.60% (P=0.0071), associated with malignant hypertension, HHF, diabetes, CKD, and scleroderma.

Conclusions:

  • Both mortality and urgent dialysis rates following AHT have significantly increased.
  • Aging populations, complex comorbidities, and HHF are major contributors to rising AHT mortality trends.
Abstract

Keywords:
chronic kidney diseasedeathdialysisepidemiologyhypertension

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