REVEALING GENDER DYNAMICS IN HYPERTENSIVE URGENCY MANAGEMENT: INSIGHTS FROM A TERTIARY HOSPITAL

Objective: To evaluate sex-based differences in clinical presentation, treatment, and management of hypertensive urgencies. Design and method: A retrospective analysis of 2,769 adults with hypertensive urgencies was conducted. Sex-based differences in treatment (captopril, benzodiazepines, alpha/beta-blockers, diuretics, nitroglycerin, CCBs) and diagnostic tests (electrocardiograms, chest radiographs, echocardiograms, computed tomography, fundoscopy) were assessed using chi-square tests. Results: Hypertensive urgencies were more frequent in females (38–59/10,000 vs. 27–42/10,000), who were significantly older than males (71 vs. 64 years, p < 0.001). Men exhibited higher DBP at presentation, intermediate, and discharge stages (p < 0.001), while SBP was comparable. Medication non-adherence and target organ damage (TOD) were more common in males, while anxiety predominated in females (p < 0.05). Symptomatically, males presented more often with dyspnea and chest pain, whereas females reported headache and general malaise. Regarding treatment, captopril was administered to 46.84% of patients with no sex-based differences (p > 0.05). Males received significantly more alpha-blockers, beta-blockers, and nitroglycerin (p < 0.05), while females were prescribed more benzodiazepines and analgesics (p = 0.012). The use of diuretics (15.17%) and CCBs (10.51%) did not differ between sexes. For diagnostic tests, only chest radiographs were performed more often in males (58.3% vs. 48.4%, p < 0.01). Other tests, including electrocardiograms (82.6%), echocardiograms (3.7%), cranial computed tomography (13.6%), thoracic computed tomography (2.2%), and fundoscopy (3.6%), showed no significant differences. At discharge, treatment changes were slightly more frequent in males (p < 0.05). Males received more recommendations on adherence, diet, and physical activity, while females were referred more often to primary care follow-up. Men were more likely to require hospital admission or referral to cardiology (p < 0.05). Conclusions: There are slight but clinically relevant sex-based differences in hypertensive urgency management. Recognizing these differences can support more tailored, symptom-driven management strategies for hypertensive urgencies.