Hypertension-associated hospitalizations and costs in the United States, 1979–2006

Figures & data

Figure 1. Age-standardized hypertension hospitalization, total and by first and second diagnosis.

Figure 2. Age-standardized hospitalization rates for hypertension by sex.

Figure 3. Age-standardized hypertension-related hospitalization by age, 1979–2006.

Table I. Characteristics of patients hospitalized with a primary or secondary diagnosis of hypertension, National Hospital Discharge Survey, 1979–2006.

	1979–1982	1991–1994	2003–2006	RPC
Age (mean ± SD)	64.5 ± 14.1	67.3 ± 14.2	67.8 ± 15.0	+ 5.1
Insurance (%)
Private	61.7	48.7	44.4	− 28.0
Public	37.7	46.5	49.8	+ 32.1
No	0.6	4.8	5.8	+ 866.7
Median length of stay (day)	7	5	3	− 57.1
First-listed diagnosis (%)
Hypertension	18.2	7.2	4.9	− 73.1
Coronary heart disease	10.5	14.7	10.1	− 3.8
Stroke	7	7.5	5.3	− 24.3
Heart failure	2.1	4.8	5.1	+ 142.9
Other CVD	7.5	8	8.5	+ 13.3
Kidney disease	3.1	2.7	4.1	+ 32.3
Diabetes	5.3	2.8	2.5	− 52.8
All others	46.2	52.3	59.4	+ 28.6
CCI (mean ± SD)	1.01 ± 1.37	1.19 ± 1.55	1.30 ± 1.53	+ 28.7
Discharge status (%)
Home	85.7	78.5	72.7	− 15.16
Other short-term facilities	3.6	4.6	5.9	+ 63.9
Long-term facilities	2.8	8.3	12.5	+ 346.4
Against medical advice	0.5	0.7	0.8	+ 60.0
Death	3.3	2.7	1.9	− 42.4
Unknown	4	5.3	6.3	+ 57.5

RPC, relative percentage change (calculated from changes from 1979–1982 to 2003–2006 and divided by 1979–1982); CVD, cardiovascular disease; CCI, Charlson Comorbidity Index.

Table II. Odds ratio of in-hospital death among patients hospitalized with hypertension, National Hospital Discharge Survey, 1979–2006.

	Odds ratio	95% Confidence interval	p
Age (years)
25–64	1.00
65–74	1.66	1.65–1.67	< 0.0001
≥ 75	3.67	3.66–3.68	< 0.0001
Sex
Male	1.00
Female	0.83	0.82–0.84	< 0.0001
Insurance
Private	1.00
Public	1.26	1.25–1.27	< 0.0001
None	1.23	1.22–1.23	< 0.0001
Period in which hospitalized
1979–1982	1.00
1983–1986	0.75	0.75–0.76	< 0.0001
1987–1990	0.75	0.74–0.75	< 0.0001
1991–1994	0.67	0.66–0.67	< 0.0001
1995–1998	0.60	0.59–0.60	< 0.0001
1999–2002	0.53	0.52–0.53	< 0.0001
2003–2006	0.45	0.44–0.45	< 0.0001
Charlson Comorbidity Index	1.28	1.27–1.28	< 0.0001
First diagnosis^a
Hypertension	1.00
Coronary heart disease	1.67	1.66–1.68	< 0.0001
Stroke	3.23	3.21–3.25	< 0.0001
Heart failure	1.46	1.45–1.47	< 0.0001
Other CVD	1.41	1.40–1.42	< 0.0001
Kidney disease	1.33	1.32–1.34	< 0.0001
Diabetes	0.87	0.86–0.88	< 0.0001

^aOdds ratio for each co-morbidity condition expressed as yes vs no. CVD, cardiovascular disease.

Table III. Costs of hospitalizations with a hypertension diagnosis during 1979–1982 and 2003–2006, National Hospital Discharge Survey.

	1979–1982			2003–2006
	1st diagnosis	2nd diagnosis	Total	1st diagnosis	2nd diagnosis	Total
Number of such hospitalizations (million)	1.86	8.35	10.21	2.05	39.81	41.86
4-year hospital cost^a (US$ billion)	3.80	17.05	20.85	17.42	337.54	354.95
Annual hospital cost (US$ billion)	0.95	4.26	5.21	4.35	84.38	88.74
Value of annual hospital cost in 2008 dollars^b (US$ billion)	7.33	32.89	40.22	5.56	107.83	113.39

^aBased on the average cost per stay of US$2041 during 1979–1982 (US Census Bureau, Statistical Abstract of the United States, 1990), and US$8480 during 2003–2006 (US Census Bureau, Statistical Abstract of the United States, 2008).

^bUsing the consumer price indices of medical care prices (hospital and related services) to inflate to year 2008 dollars: 1980–2008. US Census Bureau, Statistical Abstract of the United States, 2010.