Hypertensive Urgency: An Emergency Department Pipeline to Primary Care Pilot Study.

American Journal of Hypertension
Antonio A GiaimoStephen J Huot

Abstract

Optimal triage of patients with hypertensive urgency (HU) in the emergency department (ED) is not well established. 2017 ACC/AHA hypertension (HTN) guidelines recommend treatment initiation and follow-up within 1 week. Objectives of our pilot study were to evaluate feasibility and impact of directly connecting ED patients with HU to outpatient HTN management on blood pressure (BP) control and ED utilization. ED patients with HU and no primary care physician were scheduled by a referral coordinator for an initial appointment in a HTN clinic embedded within a primary care practice. BP control and ED utilization over the subsequent 90 days were tracked and compared with BP at time of the referral ED visit, and ED utilization in the 90 days preceding referral. Data are reported for the first 40 referred patients. Average time to first visit was 7.8 days. Mean age was 51 years (range 28-76), 75% were African-American, and mean pooled 10-year atherosclerotic cardiovascular disease (ASCVD) risk was 20.8%. Mean BP declined from 198/116 mm Hg at ED visit to 167/98 mm Hg at HTN clinic visit 1 to 136/83 by 6 weeks and was sustained at 90 days. Total ED visits for the group decreased from 61 in the 90 days prior to referral, to 18 in the 9...Continue Reading

References

May 16, 2003·JAMA : the Journal of the American Medical Association·Aram V ChobanianUNKNOWN National High Blood Pressure Education Program Coordinating Committee
Jul 27, 2007·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·Brigitte M BaumannEdwin D Boudreaux
Jul 12, 2013·Annals of Emergency Medicine·Stephen J WolfUNKNOWN American College of Emergency Physicians Clinical Policies Committee
Oct 12, 2015·The American Journal of Cardiology·Candace D McNaughtonPhillip Levy
Nov 8, 2015·Journal of the American Board of Family Medicine : JABFM·Randell WexlerAnn Scheck McAlearney
May 12, 2016·Current Hypertension Reports·Aaron BrodyPhillip Levy
Jun 14, 2016·JAMA Internal Medicine·Krishna K PatelMichael B Rothberg
Jun 14, 2016·JAMA Internal Medicine·Iona Heath

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Citations

Apr 7, 2021·American Journal of Hypertension·Ernesto L Schiffrin

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