Atzema CL, et al. - Researchers determined the proportion of emergency department (ED) visits for hypertension that happened after a blood pressure (BP) measurement with a self-measuring device and the associated outcomes. In this retrospective observational study, they identified that nearly half of patients with an ED visit that was primarily for hypertension presented after elevated readings on self-measurement devices. Hospital admission was reported for only 3% of these patients.

Methods

• Between April 2010 and March 2011, retrospective observational study including adults who made an ED visit and received a primary diagnosis of hypertension at 1 of 5 community and tertiary hospitals in Ontario, Canada was performed.
• ED visits were split into four categories based on what prompted the visit: a home BP reading, a pharmacy reading, as a result of a physician referral, and all others (termed “not documented”).
• Groups were examined regarding rates of admission to the hospital, ED treatment (administration of antihypertensive medication and prescription provision), and post-ED clinical events (follow-up care, return ED visits, and long-term all-cause mortality).

Results

• Researchers analyzed 1,508 patients with median presenting ED BP of 182/97 mm Hg (interquartile range 164 to 200/85 to 109 mm Hg).
• In this work, 40.9%, 8.3%, 13.3%, and 37.5% represent the percentage of patients presenting to the ED after a reading at home, at a pharmacy, or by physician referral and the remaining patients not documented, respectively.
• Overall, 109 patients (7.2%) were admitted to the hospital.
• The proportion of patients admitted after a home or pharmacy reading, after a physician referral, or who were not documented was 3.1%, 11.9%, and 11.0%, respectively.
• Two-year mortality rates were 5.4%, 0.0%, 6.5%, and 5.3% for the home, pharmacy, physician referral, and not documented groups, respectively.