Diagnosing Possible Hypertension When Blood Pressure Is High in The Emergency Department
Published date | 01 September 2011 |
DOI | http://doi.org/10.2202/1948-4682.1179 |
Author | Richard W. Niska |
Date | 01 September 2011 |
Volume 3, Issue 3 • 2011 • Article 2
Diagnosing Possible Hypertension When Blood Pressure Is
High in The Emergency Department
Richard W. Niska, Centers for Disease Control and Prevention
Niska, Richard W. (2011) "Diagnosing Possible Hypertension When Blood Pressure Is High in The
Emergency Department," World Medical & Health Policy: Vol. 3: Iss. 3, Article 2.
Available at: http://www.psocommons.org/wmhp/vol3/iss3/art2
DOI: 10.2202/1948-4682.1179
©2011 Policy Studies Organization
Diagnosing Possible Hypertension When
Blood Pressure Is High in The Emergency
Department
Richard W. Niska, Centers for Disease Control and Prevention
Abstract
Purpose: Emergency physicians refer to primary care for follow-up of conditions identified
in the emergency department (ED). Hypertension is a major risk factor for cardiovascular disease.
Its detection is key in decreasing morbidity and mortality. We examined factors associated with
diagnosing possible hypertension in patients with high blood pressure (BP), as a first step in
outpatient referral.
Methods: Data from a national ED survey were examined for visits by adults with high BP.
The dependent variable was a hypertension diagnosis. Independent variables were BP elevation
stage, age, sex, ethnicity, payment, year, pain severity, and urban versus rural location. Bivariate
associations were tested between all independent variables and a diagnosis of possible
hypertension. Logistic regression models determined significant predictors of a hypertension
diagnosis.
Results: Only 5.5 percent of ED patients with high BP were diagnosed with hypertension.
Predictors included stage 2 BP elevation, age over 30 years old, females, minority ethnic groups,
and mild or no pain.
Conclusions: This analysis suggests associated factors influencing the diagnosis of
hypertension in the ED to facilitate referral, which can have significant benefits in reducing
complications of untreated hypertension.
KEYWORDS: hypertension, high blood pressure, emergency department
Author Notes: Disclaimers: The author has no financial conflicts of interest or external funding
sources. The views presented in this article are the author’s and do not necessarily reflect those of
the U.S. Centers for Disease Control and Prevention (CDC). Prior Presentations Poster presentation
at annual meeting of the Society for Academic Emergency Medicine, Boston, Massachusetts,
June 4, 2011 Accepted for oral presentation at U.S. Public Health Service Scientific and Training
Symposium, New Orleans, Louisiana, June 22, 2011 Corresponding Author Richard W. Niska, MD
CDC, National Center for Health Statistics 3311 Toledo Road, Room 3319 Hyattsville, Maryland
20782 Phone: (301) 458-4340 Fax: (301) 458-4693 Rniska@cdc.gov (may be published) Reprints
not available from author
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