The worldwide prevalence of hypertension is around 31%, exceeding 1.3 billion people.[2]Mills KT, Bundy JD, Kelly TN, et al. Global disparities of hypertension prevalence and control: a systematic analysis of population-based studies from 90 countries. Circulation. 2016 Aug 9;134(6):441-50.
http://circ.ahajournals.org/content/134/6/441.long
http://www.ncbi.nlm.nih.gov/pubmed/27502908?tool=bestpractice.com
[3]Kearney PM, Whelton M, Reynolds K, et al. Global burden of hypertension: analysis of worldwide data. Lancet. 2005 Jan 15-21;365(9455):217-23.
http://www.ncbi.nlm.nih.gov/pubmed/15652604?tool=bestpractice.com
[4]Bloch MJ. Worldwide prevalence of hypertension exceeds 1.3 billion. J Am Soc Hypertens. 2016 Oct;10(10):753-4.
http://www.ncbi.nlm.nih.gov/pubmed/27660007?tool=bestpractice.com
Of these, 1% to 2% will suffer a hypertensive crisis in their lifetime.[5]Martin JF, Higashiama E, Garcia E, et al. Hypertensive crisis profile. Prevalence and clinical presentation. Arq Bras Cardiol. 2004 Aug;83(2):131-6.
http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0066-782X2004001400004&lng=en&nrm=iso&tlng=en
http://www.ncbi.nlm.nih.gov/pubmed/15322655?tool=bestpractice.com
[6]Deshmukh A, Kumar G, Kumar N, et al. Effect of Joint National Committee VII report on hospitalizations for hypertensive emergencies in the United States. Am J Cardiol. 2011 Sep 3;108(9):1277-82.
http://www.ncbi.nlm.nih.gov/pubmed/21890093?tool=bestpractice.com
Rates of hypertensive emergencies have increased over the past 20 years; however, mortality rates have decreased and range from 0.2% to 11.0%.[7]Bress AP, Anderson TS, Flack JM, et al. The management of elevated blood pressure in the acute care setting: a scientific statement from the American Heart Association. Hypertension. 2024 Aug;81(8):e94-106.
https://www.ahajournals.org/doi/full/10.1161/HYP.0000000000000238
http://www.ncbi.nlm.nih.gov/pubmed/38804130?tool=bestpractice.com
[8]Shah M, Patil S, Patel B, et al. Trends in hospitalization for hypertensive emergency, and relationship of end-organ damage with in-hospital mortality. Am J Hypertens. 2017 Jul 1;30(7):700-6.
https://academic.oup.com/ajh/article/30/7/700/3743788?login=false
http://www.ncbi.nlm.nih.gov/pubmed/28430850?tool=bestpractice.com
[9]Janke AT, McNaughton CD, Brody AM, et al. Trends in the incidence of hypertensive emergencies in US emergency departments from 2006 to 2013. J Am Heart Assoc. 2016 Dec 5;5(12):e004511.
https://www.ahajournals.org/doi/10.1161/JAHA.116.004511
http://www.ncbi.nlm.nih.gov/pubmed/27919932?tool=bestpractice.com
Men may be more likely than women to suffer a hypertensive emergency. Hypertensive emergency is more common in older patients and in black people.[10]Alshami A, Romero C, Avila A, et al. Management of hypertensive crises in the elderly. J Geriatr Cardiol. 2018 Jul;15(7):504-12.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6198269
http://www.ncbi.nlm.nih.gov/pubmed/30364798?tool=bestpractice.com
[11]Waldron FA, Benenson I, Jones-Dillon SA, et al. Prevalence and risk factors for hypertensive crisis in a predominantly African American inner-city community. Blood Press. 2019 Jan 22;28(2):114-23.
http://www.ncbi.nlm.nih.gov/pubmed/30669866?tool=bestpractice.com
[12]Hyman DJ, Pavlik VN. Characteristics of patients with uncontrolled hypertension in the United States [published correction appears in N Engl J Med. 2002 Feb 14;346(7):544]. N Engl J Med. 2001 Aug 16;345(7):479-86.
https://www.nejm.org/doi/full/10.1056/NEJMoa010273?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed
http://www.ncbi.nlm.nih.gov/pubmed/11519501?tool=bestpractice.com
[13]Benenson I, Waldron FA, Jadotte YT, et al. Risk factors for hypertensive crisis in adult patients: a systematic review. JBI Evid Synth. 2021 Jun;19(6):1292-327.
http://www.ncbi.nlm.nih.gov/pubmed/33555818?tool=bestpractice.com
Preeclampsia complicates 2% to 8% of pregnancies globally.[14]Steegers EA, von Dadelszen P, Duvekot JJ, et al. Pre-eclampsia. Lancet. 2010 Aug 21;376(9741):631-44.
http://www.ncbi.nlm.nih.gov/pubmed/20598363?tool=bestpractice.com
Preeclampsia is more prevalent among African American women than among white women.[15]LeFevre ML, U.S. Preventive Services Task Force. Low-dose aspirin use for the prevention of morbidity and mortality from preeclampsia: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2014 Dec 2;161(11):819-26.
https://www.acpjournals.org/doi/full/10.7326/M14-1884
http://www.ncbi.nlm.nih.gov/pubmed/25200125?tool=bestpractice.com
[16]Jeyabalan A. Epidemiology of preeclampsia: impact of obesity. Nutr Rev. 2013 Oct;71 Suppl 1(0 1):S18-25.
https://academic.oup.com/nutritionreviews/article/71/suppl_1/S18/1834571
http://www.ncbi.nlm.nih.gov/pubmed/24147919?tool=bestpractice.com
[17]Sheehy S, Aparicio HJ, Xu N, et al. Hypertensive disorders of pregnancy and risk of stroke in U.S. black women. NEJM Evid. 2023 July 6;2(10). Differences in prevalence may be, in part, due to African American women being disproportionately affected by risk factors for preeclampsia.[16]Jeyabalan A. Epidemiology of preeclampsia: impact of obesity. Nutr Rev. 2013 Oct;71 Suppl 1(0 1):S18-25.
https://academic.oup.com/nutritionreviews/article/71/suppl_1/S18/1834571
http://www.ncbi.nlm.nih.gov/pubmed/24147919?tool=bestpractice.com
African American women also have case fatality rates related to preeclampsia three times higher than rates among white women.[16]Jeyabalan A. Epidemiology of preeclampsia: impact of obesity. Nutr Rev. 2013 Oct;71 Suppl 1(0 1):S18-25.
https://academic.oup.com/nutritionreviews/article/71/suppl_1/S18/1834571
http://www.ncbi.nlm.nih.gov/pubmed/24147919?tool=bestpractice.com
Inequalities in access to adequate prenatal care may contribute to poor outcomes associated with preeclampsia in African American women.[16]Jeyabalan A. Epidemiology of preeclampsia: impact of obesity. Nutr Rev. 2013 Oct;71 Suppl 1(0 1):S18-25.
https://academic.oup.com/nutritionreviews/article/71/suppl_1/S18/1834571
http://www.ncbi.nlm.nih.gov/pubmed/24147919?tool=bestpractice.com
However, UK data concerning ethnic differences in hypertension prevalence and complications are inconsistent.[18]Kulkarni S, Glover M, Kapil V, et al. Management of hypertensive crisis: British and Irish Hypertension Society Position document. J Hum Hypertens. 2023 Oct;37(10):863-79.
https://www.nature.com/articles/s41371-022-00776-9
http://www.ncbi.nlm.nih.gov/pubmed/36418425?tool=bestpractice.com
[19]Shantsila A, Shantsila E, Beevers DG, et al. Predictors of 5-year outcomes in malignant phase hypertension: the West Birmingham Malignant Hypertension Registry. J Hypertens. 2017 Nov;35(11):2310-4.
http://www.ncbi.nlm.nih.gov/pubmed/28622157?tool=bestpractice.com
[20]Lane DA, Lip GY. Ethnic differences in hypertension and blood pressure control in the UK. QJM. 2001 Jul;94(7):391-6.
https://academic.oup.com/qjmed/article/94/7/391/1598592
Lack of insurance or a primary care doctor and nonadherence to treatment all predispose toward development of hypertensive emergency.[21]Tisdale JE, Huang MB, Borzak S, et al. Risk factors for hypertensive crisis: importance of out-patient blood pressure control. Fam Pract. 2004 Aug;21(4):420-4.
http://fampra.oxfordjournals.org/cgi/content/full/21/4/420
http://www.ncbi.nlm.nih.gov/pubmed/15249531?tool=bestpractice.com
[22]Shea S, Misra D, Ehrlich MH, et al. Predisposing factors for severe, uncontrolled hypertension in an inner-city minority population. N Engl J Med. 1992 Sep 10;327(11):776-81.
http://www.ncbi.nlm.nih.gov/pubmed/1501654?tool=bestpractice.com
As populations age globally, the prevalence of hypertension and therefore hypertensive emergency is expected to increase.[3]Kearney PM, Whelton M, Reynolds K, et al. Global burden of hypertension: analysis of worldwide data. Lancet. 2005 Jan 15-21;365(9455):217-23.
http://www.ncbi.nlm.nih.gov/pubmed/15652604?tool=bestpractice.com