Emergency Department-Provided Home Blood Pressure Devices Can Help Detect Undiagnosed Hypertension
Emergency departments (EDs) are critical sites for hypertension (HTN) screening. Home blood pressure (BP) monitoring (HBPM) is used routinely in outpatient settings, yet its utility after the ED visit for those with elevated BP in the ED is unclear.
In this pilot study, we assessed if HBPM could detect HTN in patients with elevated in-ED BP.
From September 2014 to July 2017, we recruited adult patients at an urban, academic ED with a triage BP ≥ 120/80 mmHg and no history of HTN into this prospective cohort observational study. After their ED visit, participants obtained BP measurements for two weeks using a validated HBPM. HTN was considered probable if the average HBPM BP was ≥ 135/85 mmHg. We calculated the proportion of participants whose ED BP measurement accurately predicted HTN using HBPM after discharge.
Of 136 participants enrolled, 93 (68%) returned the HBPM with at least four home BP measurements [mean number of measurements obtained: 29 (SD: 17, range 4–59)]. Participants’ median age was 40 years-old (IQR 34–48); 55% were female, 19% were black, and 58% were white. Forty-six percent of participants with elevated in-ED BP had HTN in follow-up.
For patients with elevated BP in the ED, HBPM could be valuable for determining which patients have HTN and require expedient follow-up.
KeywordsHypertension Quality measurement Guidelines Cardiovascular disease Blood pressure
We have received funding for this work from the Agency for Healthcare Research and Quality (T32 HS000011), Brown Emergency Medicine; and the Rhode Island Foundation.
Compliance with Ethical Standards
Conflict of interest
The authors declare that they have no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
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