title: Recognizing asymptomatic elevated blood pressure in ED patients: how good (bad) are we?
abstract: OBJECTIVE
  This study was conducted to determine if emergency medicine (EM) physicians recognize emergency department (ED) patients with asymptomatic elevated blood pressure (AEBP) by diagnosis, treatment, or referral. The study also evaluated whether differences exist in identification of AEBP based on patient age, sex, race, or insurance status.
  
  
  METHODS
  A retrospective chart review of all adult patients presenting to a tertiary care teaching hospital ED between April 1, 2004, and June 30, 2004, was performed. Patients were included if documented blood pressure(s) were 140/90 mm Hg or higher. Exclusion criteria included age younger than 18 years or older than 89 years, history of hypertension, admission, condition clearly defined by a hypertensive state, or blood pressure lower than 140/90 mm Hg.
  
  
  RESULTS
  A total of 9805 charts were reviewed; 1574 (16%) patients met inclusion criteria. The average age of our study patient was 38 +/- 14 years; 51% were women and 71.8% were African American. Only 112 patients with AEBP (7%) received attention for their elevated blood pressure (ie, diagnosis, treatment, medication prescription, and/or referral). There was no statistically significant difference between patients identified with AEBP and those not recognized by ED physicians by patient age, sex, race, or insurance status.
  
  
  CONCLUSIONS
  Emergency department physicians recognize, treat, and/or refer only a small percentage of ED patients with AEBP. No difference in identification, treatment, or referral exists based on patient age, sex, race, or insurance status.
authors.affiliation: Department of Emergency Medicine, Eastern Virginia Medical School and Emergency Physicians of Tidewater, Norfolk, VA 23507, USA.
authors.forename: Keri
authors.initials: K
authors.lastname: Tilman
authors.forename: Mini
authors.initials: M
authors.lastname: DeLashaw
authors.forename: Sean
authors.initials: S
authors.lastname: Lowe
authors.forename: Sandy
authors.initials: S
authors.lastname: Springer
authors.forename: Susan
authors.initials: S
authors.lastname: Hundley
authors.forename: Francis L
authors.initials: FL
authors.lastname: Counselman
mesh_terms: D000328:Adult; D000368:Aged; D001794:Blood Pressure; D016001:Confidence Intervals; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis* / Q000188:drug therapy; D007348:Insurance, Health; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies