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Hypertension in the ED: still an unrecognized problem.
James E Svenson1, Michael Repplinger
1Section of Emergency Medicine, University of Wisconsin, Madison, WI 53792, USA. jes@medicine.wisc.edu
The American Journal of Emergency Medicine
|October 18, 2008
Summary
Elevated blood pressure is common in emergency departments, affecting 26% of patients, but is often unrecognized, especially in children. Follow-up care for hypertension is rarely recommended, despite persistent high readings in nearly half of affected individuals.
Area of Science:
- Emergency Medicine
- Cardiology
- Public Health
Background:
- Hypertension is a widespread condition with significant implications for patient health.
- Emergency Department (ED) follow-up studies indicate that elevated blood pressure persists in up to 50% of patients.
- ED screening for hypertension is a recommended practice, yet blood pressure elevations are frequently overlooked or misattributed to pain or anxiety.
Purpose of the Study:
- To determine the incidence of hypertension in the ED population.
- To assess the recognition of elevated blood pressure readings by healthcare providers.
- To evaluate the relationship between elevated blood pressure, pain scores, and patient age.
Main Methods:
- A retrospective study design was employed.
- Data from 2821 patients presenting to the ED over a one-month period were analyzed.
- Patient age, blood pressure measurements, and reported pain scores were reviewed, alongside discharge diagnoses and instructions to assess recognition and follow-up recommendations.
Main Results:
- Twenty-six percent of all patients exhibited elevated blood pressure, including 40% of pediatric patients.
- No correlation was found between pain scores and elevated blood pressure in either children or adults.
- Recognition of elevated blood pressure was minimal, with follow-up recommended in only 4% of cases. Of those with elevated readings, 47% still had high blood pressure upon discharge.
Conclusions:
- Hypertension is a common and often unrecognized issue among patients presenting to the ED.
- Elevated blood pressure readings, particularly in pediatric patients, were largely ignored.
- Acute pain or anxiety should not be the sole explanations for elevated blood pressure readings in the ED.
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