ED patients with BP elevations discharged with no documented hypertension diagnosis: study

Many patients with stage 2-range high blood pressure readings (HBPRs) in the emergency department (ED) are discharged without documented diagnosis of hypertension, reveals a study. Furthermore, most of these individuals only have a single documented blood pressure (BP).

“HBPRs are common in ED patients, but the frequency of HBPRs among [those] without a documented diagnosis of hypertension is unclear,” according to the researchers, who then set out to conduct a retrospective study of discharged ED encounters at a large academic ED in 2024.

HBPRs were defined as BP ≥130 mm Hg systolic or ≥80 mm Hg diastolic.

A total of 66,624 discharged encounters with BP data were included in the analysis. Of these, 52,461 (78.7 percent) had at least one HBPR, and 38,715 (58.1 percent) had at least one stage 2-range HBPR (≥140/90 mm Hg). Among those with stage 2-range HPBRs, 22,471 (58.0 percent) had no documented diagnosis of hypertension.

The following factors were independently associated with a documented diagnosis of hypertension: older age, female sex, Black race, absence of interpreter need, and Medicare or Medicaid coverage.

“The ED may provide an opportunity for BP reassessment and outpatient referral,” the researchers said.