Elevated Blood Pressure Among Military Emergency Department Patients

Area of Science:

• Cardiovascular Medicine
• Public Health
• Military Health

Background:

• Hypertension is a major modifiable risk factor for atherosclerotic cardiovascular disease (ASCVD).
• Limited data exist on hypertension prevalence in younger populations like military service members.
• Early detection of elevated blood pressure (BP) is critical for preventing long-term ASCVD.

Purpose of the Study:

• To determine the prevalence of elevated BP in active duty U.S. Armed Forces service members presenting to military emergency departments (EDs).
• To examine the relationship between elevated BP in EDs and subsequent hypertension diagnoses.
• To assess the diagnostic gap for hypertension in this population.

Main Methods:

• Retrospective analysis of outpatient medical encounters for active duty service members (January 2016-December 2022).
• Data sourced from administrative and electronic health records, including sociodemographic and occupational information.
• Multivariable mixed-effects regression analysis to identify factors associated with BP.

Main Results:

• 37.9% of the study population presented with elevated BP in military EDs, with only 3.4% having a prior hypertension diagnosis.
• At ED visits, 30.2% met Stage 1 and 7.7% met Stage 2 hypertension criteria.
• Within 12 months, hypertension diagnoses increased significantly, yet a substantial proportion remained undiagnosed or undertreated.

Conclusions:

• Elevated BP is highly prevalent in military EDs among active duty personnel.
• A significant gap exists between elevated BP findings and formal hypertension diagnoses.
• ED visits presenting with elevated BP warrant outpatient follow-up for timely hypertension evaluation and ASCVD risk reduction.