Category: Lipids/CV Health
Hypertension and chronic kidney disease are two of the most important risk factors for cardiovascular disease, a major cause of death in the US population. The impact of gender in this equation remains unclear, more so, on how it affects the Hispanic population. Studies comparing the outcomes and difference in inpatient mortality between male and female with hypertension and CKD are sparse. Our aim was to determine if gender in Latino population affect the inpatient survival rate among hypertensive patients across different CKD stages.
Data was extracted from the 2005 to 2012 Nationwide Inpatient Sample (NIS). Using propensity score matching, female hypertensive with chronic kidney disease (stage 3, 4, 5 or ESRD) patients were matched with hypertensive males at a 1:1 ratio. We compared inpatient mortality, both crude mortality and mortality per CKD stage, length of stay and total hospital charges between male and females. Analyses were performed using SAS version 9.3 (SAS Institute, Cary, NC, USA).
Among 227,923 hospitalized hypertensive patients, 118,132 (51.83%) were males and 109,791 (48.17%) females. 18.76%, 10.31%, 3.85% and 67.17% were Females with CKD 3 to ESRD respectively. Males across CKD stages 3 to ESRD were 19.47%, 9.54%, 3.63% and 67.43% respectively. In-hospital crude mortality was significantly higher for males compared to group of females before match, (3.89 vs 3.74 p= 0.05), interestingly, mortality was higher after match for females (3.85 vs 3.79 p= 0.48). Mean length of stay for hypertensive females were significantly higher than males, irrespective of CKD stage (6.74 vs 6.70 days, p= 0.001), however at the male group had an expense of higher hospital charges (63,686 vs 61,667 dollars, p= 0.001).
Latino hypertensive men with any stage of CKD are more at risk of dying then their counterpart women and have higher hospital charges.
Conclusion : Further studies are needed to explore these associated genders in difference outcomes in this population.
Endocrinology fellow 1st year
University of Arizona College of Medicine, Phoenix
Endocrinology, diabetes and metabolism fellowship director
University of Arizona College of Medicine-Phoenix and Phoenix VA
Ricardo Correa, M.D., Es. D., F.A.C.P., C.M.Q. is an Assistant Professor of Medicine and Program Director for the Endocrinology, Diabetes and Metabolism of the University of Arizona College of Medicine-Phoenix and the Warren Alpert Medical School of Brown University in the department of Endocrinology, Diabetes and Metabolism. He is the chair of the young physician subcommittee of the American Association of Clinical Endocrinologist (YPS-AACE). Also he is editor of Dynamed and outreach unit director of Endotext.org and Thyroid manager and editorial board of multiple endocrine and internal medicine journals.
He completed his Medical School and Education Master at University of Panama. He completed a research fellowship in Epidemiology and Tropical disease at ICGES in Panama City and his internal medicine residency at Jackson Memorial hospital-University of Miami (UM) program. In 2012, he was honored with the AOA and GoldDOC Award from the UM. Then he pursued his clinical and research fellowship in endocrinology with special focus in neuroendocrinology and adrenals at National Institute of Health.
He was trained in Evidence-based Medicine at McMaster University in Canada and in Editorial process and OJS by LATINDEX. He is co-director of the Panamanian Cochrane Center and EBM advocate.
Dr. Correa has been involved in organized medicine since medical school. He has been scientific committee chair and vice speaker for the AMA-RFS, chair of the CoA for the ACP FC, Board of Trustee of the Maryland Medical Society, National Secretary of the CoA for the NHMA, Regional Vice President of the CIR, Medical Education Officer of JDN-WMA. He has been involved with local, regional and national organization in the area of medical education, leadership and physician wellbeing including the AMA joy in medicine organization, ACGME at different level including the duty hour task force, NBME as part of the board, NBPAS and other organization.
At AACE and ACE and Endocrine Society, Dr. Correa has occupied different position from been the fellow-in-training board of director member to member and advisor of multiple committees throughout the years.
Dr. Correa has been involved in multiple academic, scientific and educational activities including article Consultant, Interpretation of the Medical Literature Project, NBME, International Committee member of the Committee on publications ethics (COPE), World Association of Medical Editors, Deputy Editor of International Archives of Medicine, Editorial board and peer reviewer of multiple journals including Annals of Public Health, PAHO journal, SGIM journal, International Journal of Endocrinology, International Journal of Diabetes, International Journal of Clinical Cases and Images, International journal of case reports, etc. Also he is consultant for Latinamerican science center including Bolivia and Panama national science department.
He is board certified in Medical Quality. He is the author of the book title “Case report: basics and publication”. His research is focus on neuroendocrinology mainly on pituitary and adrenal tumor and new genetic mutations.