Authors: Adesuwa Akhetuamhen, Kristin Bibbins-Domingo, Jahan Fahimi, Valy Fontil, Robert Rodriguez, Ralph C Wang
Published in: Journal of Emergency Medicine, January 10, 2024
Conclusions:
The study highlights a substantial gap in the diagnosis and management of asymptomatic hypertension in U.S. EDs. Despite adherence to clinical policies recommending delayed treatment for aHTN, there remains a significant number of missed opportunities for diagnosing this condition. This suggests the need for enhanced strategies to identify and manage aHTN in emergency settings to potentially improve long-term health outcomes.
Methods:
The study utilized data from the 2016-2019 National Hospital Ambulatory Medical Care Surveys. Asymptomatic hypertension was defined as adult patients with a blood pressure reading ≥160/100 mm Hg at both triage and discharge without trauma or signs of end-organ damage. Patients were further categorized into two subgroups based on their blood pressure levels: 160-179/100-109 mm Hg and >180/110 mm Hg.
Results:
- Of the total ED visits during the study period, 5.9% were identified as having aHTN.
- About 74% of these patients were discharged home, equating to approximately 26.5 million visits.
- Among the higher aHTN subgroup (>180/110 mm Hg) discharged home, 13% were diagnosed and 3.9% were treated for aHTN.
- In the lower aHTN subgroup (160-179/100-109 mm Hg), diagnosis and treatment rates were considerably lower at 3.1% and 1.2%, respectively.