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The aim of this study was to investigate gender inequality regarding cardiovascular (CV) risk factors and comorbidities in hypertensive (HTN) patients admitted for severe HTN urgencies uncontrolled in the emergency department (ED).

Design and method:

Starting from all hypertensive patients admitted to the Internal Medicine Clinic between December 2012 and December 2015 (5762 pts) we studied those admitted for severe HTN urgencies that did not respond to treatment in the ED and thus necessitated further observation/intervention to obtain blood pressure (BP) control. Patients with HTN emergencies – stroke, acute coronary syndromes (ACS), pulmonary edema, acute renal failure/acutely decompensated chronic renal disease (CRD), were excluded. This population was further evaluated for CV risk factors and comorbidities focusing on gender differences.


Females admitted with severe refractory HTN urgencies had a significantly higher CV burden – they were more frequently obese, diabetic, dyslipidemic. These patients had already a more complex CV history including chronic heart failure (CHF), stroke, coronary heart disease (CHD), atrial fibrillation (AF) and peripheral artery disease (PAD). However, the presence of sleep apnea syndrome and COPD was evidently more frequent in males. See table.


The beneficial effects of sex hormones on the cardiovascular system in premenopausal women has been substantially proven. However, with ageing, the female population loses these benefits. Our results show that in a population with high prevalence of dyslipidemia, obesity and diabetes, females had a significantly higher prevalence of both history of major CV events and established target organ damage.

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