High Blood Pressure: A Growing Problem in EDs

A recent analysis indicates that hypertension is a highly prevalent, significant issue for physicians nationwide, including those practicing in emergency medicine. Since 2001, the emergency department (ED) component of the CDC’s annual National Hospital Ambulatory Medical Care Survey (NHAMCS) has collected data on blood pressure  measurements recorded in ED settings. The CDC’s National Center for Health Statistics (NCHS) published a brief report on BP measurements at ED visits in adults using data from the  NHAMCS ED. A significant finding was that elevated BP was more common at visits to the ED than at visits to primary care providers (Figure 1). High BP Common in the ED Severely elevated BP was found at 16.3% of ED visits, compared with 6.8% of primary care visits. Moderately high BP was found at 27.2% of ED visits, compared with 20.2% of primary care visits. For the report, moderately elevated BP was defined as a systolic BP reading of 140 to 159 mm Hg or a diastolic reading of 90 to 99 mm Hg. Severely high BP was defined as a measurement of 160/100 mm Hg or greater. “Emergency physicians see many patients every day, many of whom are elderly,” says Stephen R. Pitts, MD, MPH. “These individuals often have BP levels higher than 160/100 mm Hg.” The CDC report also indicated that both severely and moderately elevated BP at ED visits were most common among men (Figure 2) and older age groups. Severely elevated BP was more common at ED visits by non-Hispanic African-Americans (19.7%), followed by Non-Hispanic Caucasians (15.3%) and Hispanics (15.3%). Severely elevated BP was also more common at ED visits...