Abstract
Background Cardiovascular (CV) readmissions after heart failure (HF) hospitalization represent a significant source of morbidity and healthcare burden. Although hypertension (HTN) is a key precursor of HF, its impact on CV-specific readmissions after discharge is less well characterized. Methods We conducted a retrospective cohort study using the Nationwide Readmissions Database, spanning 2016 to 2022. Adult patients hospitalized with a primary diagnosis of HF were included. CV-specific readmissions within 30 days and one year were identified using ICD-10 codes for HTN, HF, myocardial infarction, arrhythmias, stroke, and thromboembolic conditions. Demographic, clinical, and hospital-level variables were evaluated to identify factors associated with readmission risk. Results Among 31,886,859 weighted hospitalizations for HF, HTN, or HTN crisis, HTN crisis was the most frequent cause of CV-specific readmissions, comprising 64.80% (N=20,662,685) of 30-day and 65.10% (N=20,758,345) of one-year events. All comparisons vs. HTN were highly significant (p<0.001) with large effect sizes (phi-coefficients=0.53-0.69). Conclusion HTN is the most frequent diagnosis leading to CV-specific readmissions after HF discharge. These findings underscore the need for prioritized BP management to prevent recurrent admissions and improve outcomes.