New study: 'Hypertension itself is not an emergency'

Research suggests that high blood pressure without any other emergency symptoms is cause for a doctor visit, not a trip on the ambulance


WASHINGTON — A study published online in the Annals of Emergency Medicine suggests that high blood pressure itself, unless paired with traditional symptoms of stroke, renal failure or heart failure were unlikely to warrant visits to the ER.

"We encourage patients to monitor their blood pressure at home if they have been diagnosed with hypertension, but not every high blood pressure reading is an emergency," said lead study author Clare Atzema, MD, an emergency physician at Sunnybrook Health Sciences Centre in Toronto.

Atzema suggests that an increase in hypertension-related ER visits may be the result of an increasingly educated public that has more aggressively monitored their own blood pressure.

During the study period, visits to Ontario emergency departments for hypertension increased from 15,793 to 25,950 per year. However, researchers observed that the percentage of patients who were actually admitted to the hospital primarily for complaints related to hypertension actually decreased.

Furthermore, the mortality for patients complaining of high blood pressure was very low: less than 1 percent of patients died within 90 days, and only 4.1 percent died within 2 years. Among the hypertensive ER patients who were later admitted into the hospital, the most frequent hospital diagnoses were stroke, renal failure and heart failure.

"Stroke remains a huge killer and we do appreciate patients with hypertension being so conscientious about monitoring their readings," said Dr. Atzema. "Patients should be aware that unless their high blood pressure coincides with symptoms of a medical emergency, such as chest pain, severe headache, nausea or shortness of breath, they probably do not need to visit the ER. If there is any doubt, come to the emergency department: we would rather have you come without an emergency than stay home with one."

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