Lu Y, Wang Y, Spatz ES, et al. - Findings demonstrate substantial and significant increase in hospitalization rates for hypertensive emergencies from 1999 to 2019 in Medicare fee-for-service beneficiaries aged 65 years or older.

• In the US population, hypertension control has not improved in the past 2 decades.

• In this serial cross-sectional study, a total of 397,238 individual Medicare fee-for-service beneficiaries aged 65 years or older were included (between 1999 and 2019).

• A significant increase in annual hospitalization rates for acute hypertension, from 51.5 to 125.9 per 100,000 beneficiary-years, was observed from 1999 through 2019.

• Most pronounced absolute increase was evident in adults ≥85 years (66.8–274.1), females (64.9–160.1), Black people (144.4–369.5), and Medicare/Medicaid insured (dual-eligible,93.1–270.0).

• The highest hospitalization rate was noted in Black adults in 2019 across age, gender, race and ethnicity, and dual-eligible strata.

• A significant national variation was observed, with the highest rates generally in the South.

• The 30-day and 90-day all-cause death rates, in patients hospitalized for acute hypertension, showed reduction from 2.6% and 5.6% to 1.7% and 3.7% and 30-day and 90-day all-cause readmission rates also reduced from 15.7% and 29.4% to 11.8% and 24.0%.