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Routine testing in patients with asymptomatic elevated blood pressure in the ED
Daniel K Nishijima1, Lorenzo Paladino, Richard Sinert
1Department of Emergency Medicine, State University of New York, Downstate Medical Center, Brooklyn, NY 11203, USA. daniel.nishijima@ucdmc.ucdavis.edu
The American Journal of Emergency Medicine
|February 18, 2010
Summary
In emergency departments, many African Americans with high blood pressure but no symptoms have abnormal lab results requiring admission. Routine serum creatinine testing is recommended for this population.
Area of Science:
- Nephrology
- Cardiology
- Emergency Medicine
Background:
- Asymptomatic elevated blood pressure in the emergency department lacks clear diagnostic guidelines.
- The prevalence of basic metabolic profile abnormalities and diminished renal function in this population is not well-established.
Purpose of the Study:
- To determine the prevalence of basic metabolic profile abnormalities leading to hospital admission in patients with asymptomatic elevated blood pressure.
- To assess the prevalence of diminished renal function in this patient group.
Main Methods:
- A cross-sectional study was conducted in two urban teaching emergency departments.
- Adult patients with diastolic blood pressure ≥100 mm Hg and no symptoms of acute end-organ damage were enrolled.
- Basic metabolic profiles were analyzed, and renal function was assessed using estimated glomerular filtration rate.
Main Results:
- Out of 167 patients, 7.2% were admitted due to abnormal basic metabolic profile results.
- 16.2% of patients exhibited diminished renal function (glomerular filtration rate <60 mL/min/1.73 m²).
- The study population was predominantly African American.
Conclusions:
- A significant proportion of African American patients presenting to the ED with asymptomatic elevated blood pressure have abnormal basic metabolic profiles necessitating admission.
- Routine serum creatinine testing is recommended for African American patients with asymptomatic elevated blood pressure in the ED to identify potential renal issues.
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