Hypertension in Australia

In this section, hospitalisations for hypertensive disease comprising essential/primary hypertension, hypertensive heart disease, hypertensive kidney disease, hypertensive heart and kidney disease and secondary hypertension are presented.

Data presented below include hospitalisations with hypertensive disease recorded as a principal or additional diagnosis. In addition, data about hospitalisations with a hypertension supplementary code recorded are also presented. Of note, there is evidence of under recording of hypertension in hospital data (Kilkenny et al. 2022; Lujic et al. 2014). See box below for definitions for hypertensive disease, hypertension, diagnosis types and supplementary code.

Hypertensive disease hospitalisations

According to the AIHW National Hospital Morbidity Database (NHMD), about 193,000 hospitalisations were recorded with hypertensive disease (principal and/or additional diagnosis) in 2023–24. This represents 1.5% of all hospitalisations in Australia.

Of the 193,000 hospitalisations with hypertensive disease in 2023–24, 9% had hypertensive disease recorded as the principal diagnosis and around 91% had the condition recorded as an additional diagnosis. 

Of all hospitalisations (principal and/or additional diagnosis) for hypertensive disease in 2023–24:

• 94% had a diagnosis of primary hypertension (also referred to as hypertension)
• 0.4% had hypertensive heart disease 
• 2.7% had hypertensive kidney disease 
• 2.0% had hypertensive heart and kidney disease 
• 0.7% had secondary hypertension.

Where hypertensive disease was the main reason for the hospitalisation (principal diagnosis), hypertension (81%) was still the most common diagnosis followed by hypertensive heart and kidney disease (10%).

Variation by age and sex

In 2023–24, hypertensive disease hospitalisation rates (principal and/or additional diagnosis):

• increased with age and was highest in the 85 and over age group for both males and females (6,100 and 7,700 per 100,000 population, respectively) (Figure 13).
• were similar for males and females after adjusting for differences in the age structure of the population (age-standardisation) (573 and 562 per 100,000 population, respectively). 

Trends over time

The number of hospitalisations with hypertensive disease as the principal and/or additional diagnosis decreased by 22% between 2015–16 and 2023–24, from 247,000 to around 193,000. The age-standardised rates decreased by 36% in the same period from 886 to 569 per 100,000 population. The decline in hospitalisation rates seen between 2018–19 and 2019–20 may partly reflect preventative measures of the early COVID-19 pandemic which had an impact on the provision of health-care services and hospital activity (AIHW 2022). 

Hypertensive disease hospitalisation rates were consistently slightly higher among males than females across the years (Figure 14).

Hypertensive disease hospitalisation variation by priority population groups

Remoteness area

In 2023–24, the age-standardised rate of hypertensive disease hospitalisations (as the principal and/or additional diagnosis) increased with remoteness area and was 1.7 times as high among people living in Remote and very remote areas as those living in Major cities (Figure 15).

Socioeconomic area

In 2023–24, the age-standardised rate of hypertensive disease hospitalisations (as the principal and/or additional diagnosis) increased with socioeconomic disadvantage with the rate for people living in the lowest socioeconomic areas 1.6 times the rate for those living in the highest socioeconomic areas (Figure 15).

Country of birth

In 2023–24, hypertensive disease hospitalisation rates (as the principal and/or additional diagnosis) varied by country of birth.

After adjusting for differences in the age structure of the populations, people born in Oceania and Antarctica, Australia, and North Africa and the Middle East had the highest hypertensive disease hospitalisation rates with those from North-East Asia, Americas and North–West Europe having the lowest rates (Figure 16).

For information about First Nations people, see Aboriginal and Torres Strait Islander (First Nations) people.

Hospitalisations with hypertension

Essential/primary hypertension is the main sub-type of hypertensive disease, accounting for 94% of all hypertensive disease hospitalisations. Because it accounts for most of the hypertensive disease hospitalisations, the pattern and trends for hypertension hospitalisation rates are similar to the hypertensive disease rates presented. Hypertension specific hospitalisation rates (principal and/or additional diagnosis) are available in the data tables.

In this section rates for hospitalisations with hypertension recorded as a supplementary code (comorbid hypertension) are presented. Supplementary chronic condition codes in hospitals data help identify key long-term health conditions that are part of a patient’s overall health profile but not the main reason for hospitalisation. It is important to note that these rates may not reflect hospitalisations due to hypertension but hospitalisations where the individual has hypertension as a coexisting condition. However, given the under identification of hypertension as a diagnosis in hospitalisations (Kilkenny et al. 2022; Lujic et al. 2014), these rates provide a picture of the extent of hospitalisations for people with comorbid hypertension. 

In 2023–24, there were around 2.4 million hospitalisations with a hypertension supplementary chronic conditions code recorded (comorbid hypertension). This represents 19% of all hospitalisations in Australia.

Variation by age and sex

In 2023–24, rates for hospitalisations with comorbid hypertension:

• increased with age, with 75% of these hospitalisations occurring in people aged 65 and over
• were highest among males and females aged 85 and over (70,500 and 61,500 per 100,000 population, respectively) (Figure 17)
• were 1.2 times as high in males as females, after adjusting for age (7,700 and 6,300 per 100,000 population, respectively).

Trends over time

The number of hospitalisations with a hypertension supplementary code increased by 40%, from 1.7 million in 2015–16, the year the supplementary chronic conditions codes were introduced, to 2.4 million in 2023–24. This increase may partly be due to changes in coding leading to increased use of the hypertension supplementary code across the years.

Age-standardised rates for hospitalisations with comorbid hypertension were consistently higher among males than females across the years (Figure 18).

Variation by priority population groups

Remoteness area

The age-standardised rate of hospitalisations with comorbid hypertension increased with remoteness in 2023–24 with the rate being 1.2 times as high among people living in Remote and very remote areas as those living in Major cities (Figure 19).

Socioeconomic area

In 2023–24, after adjusting for differences in the age structure of the population, the rate of hospitalisations with comorbid hypertension increased with socioeconomic disadvantage. The rate for people living in the lowest socioeconomic areas was 1.2 times the rate for those living in the highest socioeconomic areas (Figure 19).

Country of birth

In 2023–24, rates of hospitalisations with comorbid hypertension varied by country of birth. Age-standardised rates were highest among people born in Australia, North Africa and the Middle East, and Oceania and Antarctica and lowest in those from North-East Asia, South-East Asia and the Americas (Figure 20).

For information about First Nations people, see Aboriginal and Torres Strait Islander (First Nations) people.