Should We Diagnose and Start Hypertension Treatment in the Emergency Department?

From Journal Feed:

Spoon Feed

This was an analysis of the 2016-2019 National Hospital Ambulatory Medical Care Survey (NHAMCS) of patients presenting to the ED with asymptomatic hypertension. ED physicians infrequently diagnosed hypertension in this cohort and rarely initiated outpatient antihypertensive prescriptions.

No need to emergently treat, but consider diagnosis and outpatient management

This analysis of NHAMCS data identified 4,498 ED visits with asymptomatic hypertension (aHTN) out of 75,948 analyzed ED visits (5.9%). NHAMCS uses a “patient visit weight” variable to estimate the total number of national ED visits based on the number of reporting hospitals. Using this ‘weighted’ variable, there were an estimated 33,348,858 ED visits for aHTN during the four survey years analyzed. The authors defined aHTN as blood pressure > 160/100 mm Hg at both triage and discharge, along with no evidence of acute end organ injury, pregnancy, or other emergent conditions that cause elevated blood pressure.

Source

Missed Opportunities to Diagnose and Treat Asymptomatic Hypertension in Emergency Departments in the United States, 2016-2019. The Journal of emergency medicine vol. 66,5 (2024): e562-e570.