Co-Morbidities of Emergency Department Patients Admitted with Essential Hypertension in Florida

Purpose Although essential hypertension (EHT) has been associated with other chronic conditions, few studies have focused on co-morbidities and symptoms among patients admitted in hospital emergency departments (ED). The purpose is to compare the characteristics, co-morbidities and symptoms between ED admitted patients with three types (unspecified, benign, malignant) of EHT in Florida. Methods A public use ED data from the Florida Agency for Health Care Administration (ACHA) in 2005 was used. Records included those with primary diagnosis of three types of EHT based on the International Classification of Diseases, 9th edition (ICD 9) code. Group comparisons were made using chi square tests and linear regression models. Results Of 34,625 records, 96.3%, 2.0%, and 1.7% of them had unspecified, benign and malignant EHT, respectively. Types of EHT varied significantly by race and ethnicity, age group, principal payer, and discharge status. The most common secondary diagnoses included diabetes, abnormal lipid metabolism and hypercholesterolemia, disorder of urethra and urinary tract, hypokalemia, and anemia. While diabetes without complications was the most common co-morbidity of unspecified (10.7%) and malignant (12.3%) hypertensive patients, abnormal lipid metabolism was the most common co-morbidity of benign (20.0%) hypertensive patients. About 15.7% of benign patients had diabetes without complications. The most frequent symptom in all three groups was headache. About 60% (malignant), 34.7% (unspecified), and 4.1% (benign) of patients’ chief reasons for admission were not related to their primary diagnosis. Conclusion While co-morbidities were present in all three types of EHT, the frequencies of co-morbidities and the chief reason for ED visit differed by types. Variation in factors contributing to co-morbidities between three types of EHT should be further explored.