Hypertension Management in Emergency Departments
Miller J, McNaughton C, Joyce K, Binz S, and Levy P. Hypertension Management in Emergency Departments. Am J Hypertens 2020.
American journal of hypertension
Elevated blood pressure is pervasive among patients that visit emergency departments for their care. In this review article, we outline the current approach to the management of these individuals and highlight the crucial role emergency medicine clinicians play in reducing the morbidity associated with elevated blood pressure. We highlight the critical importance of immediate treatment when elevated blood pressure contributes to new or worsening end-organ injury but emphasize that such hypertensive emergencies are rare. For the vast majority of patients with elevated blood pressure in the emergency department who do not have new or worsening end-organ injury from elevated blood pressure, immediate blood pressure reduction within the emergency department is not recommended or safe. Nonetheless, within weeks after an emergency department visit, there is a pressing need to improve the care of patients with elevated or previously undiagnosed hypertension. For many, it may be their only regular point of engagement with the healthcare system. To address this, we present novel perspectives that envision a new role for emergency medicine in chronic hypertension management - one that acknowledges the significant population-level gaps in blood pressure control that contribute to disparities in cardiovascular disease and sets the stage for future changes in systems-based practice.
ePub ahead of print