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<p>Acute blood pressure disorders are a common yet heterogeneous clinical challenge in the Emergency Department (ED), often requiring rapid assessment and risk stratification. Among these, Hypertensive Urgency (HU) is a frequent presentation, characterized by severely elevated blood pressure (BP) without acute hypertension-mediated organ damage (HMOD). Despite its clinical relevance, sex-related differences in HU remain poorly understood. <i>.</i> This study aimed to investigate sex differences in clinical presentation, BP control and HMOD prevalence in subjects presenting with HU. Methods<i>.</i> A multicentric prospective study was conducted, enrolling symptomatic patients with HU, admitted to six Italian EDs. They were assessed within 72&#xa0;h after ED discharge to evaluate BP control and to detect subclinical HMOD.<i>.</i> A total of 257 patients were enrolled, including 134 females (52%). The mean age was 59.7 ± 14&#xa0;years, with women being significantly older than men (62.4 ± 15 vs. 56.8 ± 13, p value = 0.002). Men were more frequently active smokers and had a higher rate of diabetes and obesity. They also had higher diastolic BP, at both ED admission and discharge, and higher systo-diastolic BP at the 72-h visit. Male sex was independently associated with increased rate of HMOD—regardless of the specific organ involved—and with poor BP control at 72&#xa0;h from ED discharge. <i>.</i> Compared to women, men with HU exhibited higher BP levels and poorer BP control at 72&#xa0;h. They also showed a higher prevalence and greater severity of HMOD. Male sex emerged as independently associated with HMOD.</p> Graphical Abstract <p>Two hundred fifty-seven individuals presented to Emergency Department (ED) with a Hypertensive Urgency. The figure summarizes the main findings of the study. Men were younger, but with a higher rate of diabetes, obesity, and active smoking. Furthermore, men had a higher diastolic blood pressure (DBP) at ED presentation and discharge, as well as at 72&#xa0;h Hypertension Center reassessment. Men had a lower rate of BP control at 72&#xa0;h, as well as a higher rate of cardiac HMOD. Male sex was an independent predictor of overall HMOD, as well as of cardiac and renal organ damage when considered individually. In the figure: BP, blood pressure; DBP, diastolic blood pressure; ED, Emergency Department; HMOD, Hypertension mediated organ damage; SBP, systolic blood pressure.</p> <p></p>

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Sex-specific differences in clinical characteristics and organ damage in Hypertensive Urgencies

  • 期刊论文

  • 发表日期：

    2026年5月21日

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  • Elvira Fanelli,
  • Fabrizio Vallelonga,
  • Martina Sanapo,
  • Marco Cesareo,
  • Barbara Maria Colombo,
  • Alessandro Maloberti,
  • Ilaria Fucile,
  • Silvia Totaro,
  • Carlo Aggiusti,
  • Massimo Salvetti,
  • Costantino Mancusi,
  • Aldo Pende,
  • Cristina Giannattasio,
  • Franco Cipollini,
  • Maria Lorenza Muiesan,
  • Alberto Milan,
  • Dario Leone,
  • Salvatore Fragapani,
  • Giulia Bruno,
  • Giulia Mingrone,
  • Anna Colomba,
  • Lorenzo Airale,
  • Arianna Paladino,
  • Francesca Novello,
  • Enrico Lupia,
  • Fulvio Morello,
  • Maria Tizzani,
  • Antonella Ioverno,
  • Paola Sormani,
  • Carmine De Luca,
  • Raffaele Izzo,
  • Nicola De Luca,
  • Nicola Nesti

摘要

Acute blood pressure disorders are a common yet heterogeneous clinical challenge in the Emergency Department (ED), often requiring rapid assessment and risk stratification. Among these, Hypertensive Urgency (HU) is a frequent presentation, characterized by severely elevated blood pressure (BP) without acute hypertension-mediated organ damage (HMOD). Despite its clinical relevance, sex-related differences in HU remain poorly understood. . This study aimed to investigate sex differences in clinical presentation, BP control and HMOD prevalence in subjects presenting with HU. Methods. A multicentric prospective study was conducted, enrolling symptomatic patients with HU, admitted to six Italian EDs. They were assessed within 72 h after ED discharge to evaluate BP control and to detect subclinical HMOD.. A total of 257 patients were enrolled, including 134 females (52%). The mean age was 59.7 ± 14 years, with women being significantly older than men (62.4 ± 15 vs. 56.8 ± 13, p value = 0.002). Men were more frequently active smokers and had a higher rate of diabetes and obesity. They also had higher diastolic BP, at both ED admission and discharge, and higher systo-diastolic BP at the 72-h visit. Male sex was independently associated with increased rate of HMOD—regardless of the specific organ involved—and with poor BP control at 72 h from ED discharge. . Compared to women, men with HU exhibited higher BP levels and poorer BP control at 72 h. They also showed a higher prevalence and greater severity of HMOD. Male sex emerged as independently associated with HMOD.

Graphical Abstract

Two hundred fifty-seven individuals presented to Emergency Department (ED) with a Hypertensive Urgency. The figure summarizes the main findings of the study. Men were younger, but with a higher rate of diabetes, obesity, and active smoking. Furthermore, men had a higher diastolic blood pressure (DBP) at ED presentation and discharge, as well as at 72 h Hypertension Center reassessment. Men had a lower rate of BP control at 72 h, as well as a higher rate of cardiac HMOD. Male sex was an independent predictor of overall HMOD, as well as of cardiac and renal organ damage when considered individually. In the figure: BP, blood pressure; DBP, diastolic blood pressure; ED, Emergency Department; HMOD, Hypertension mediated organ damage; SBP, systolic blood pressure.