Hypertension in cancer patients seeking acute care: an opportunity to intervene.
BACKGROUND
The objectives were to describe clinical factors associated with hypertension or increased blood pressure in cancer patients seeking acute care, to describe the outcomes of these patients related to hypertension or increased blood pressure, and to determine whether these patients receive appropriate treatment and follow-up instructions.


METHODS
We retrospectively reviewed the records of patients admitted to the emergency center at The University of Texas M. D. Anderson Cancer Center from May 1, 2001 through August 5, 2001. Patients were included in our analysis if their emergency center triage blood pressure was 140 mm Hg or greater, systolic, or 90 mm Hg or greater, diastolic and remained in this range at emergency center discharge or if they were treated with an antihypertensive medication in the emergency center. Descriptive statistics, chi and Student t tests were utilized in the analysis.


RESULTS
Records of 143 patients were analyzed. The mean baseline, emergency center triage, and emergency center discharge blood pressure were 140/78 mm Hg, 159/84 mm Hg, and 153/81 mm Hg, respectively. Of 77 patients (54%) with controlled neoplastic disease, 54 (38%) were not receiving cancer treatment. Forty-one (30%) were admitted to the hospital and 27 (19%) returned to the emergency center with hypertension or possible hypertension-related events within 6 months. Discharge instructions regarding hypertension follow-up were documented in 9% of records.


CONCLUSIONS
Most patients (54%) had controlled cancer; more than one third were not receiving cancer treatment and had good performance status. Such patients would be likely to benefit from management of hypertension. In addition, only 9% of hypertensive patients were given hypertensive specific discharge instructions. The emergency center may provide another opportunity to alert patients of abnormal blood pressures and assist in arranging follow-up.
Escalante
Carmen P
CP
Department of General Internal Medicine, Ambulatory Treatment and Emergency Care, The University of Texas M.D. Anderson Cancer Center, Houston, Texas 77230-1402, USA. cescalan@mdacc.tmc.edu
Weiser
Mary Ann
MA
Lam
Tony
T
Ho
Vi
V
Yeung
Sai-Ching Jim
SC
D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001794:Blood Pressure; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications* / Q000503:physiopathology / Q000628:therapy*