Prevalence of undiagnosed hypertension in the emergency department.
BACKGROUND
Hypertension (HTN) is a serious health problem that threatens one fourth of the adult population in some countries.


OBJECTIVE
This study aimed to assess the prevalence and outcome of undiagnosed hypertensive patients admitted to the emergency department.


METHODS
This cross-sectional study was conducted from March 2009 to March 2010 at Imam Hossein Medical and Educational Center, Teheran, Iran. A total of 2070 patients aged 18 years and older were admitted to the emergency department without previous HTN history. Blood pressure was taken and repeated 10 minutes later if initial systolic blood pressure ≥ 140 mmHg or diastolic blood pressure ≥ 90 mmHg. Those who matched the inclusion criteria entered the study for further follow-up. A numerical pain score was also used for pain intensity assessment. Chi-Square and Mann Whitney U tests were performed to compare differences between sex, age and education of the participants.


RESULTS
Based on the inclusion criteria, 346 patients entered the study, out of which 168 qualified for further evaluation and follow-up. Forty eight patients (28.6%) were finally diagnosed with high blood pressure. Our study showed that the prevalence of undiagnosed HTN was 4.8%. Significant differences between blood pressure, age, pain score and education level (P < 0.001) were found. This implies that old age, poor education and low pain score are positively associated with hypertension.


CONCLUSIONS
Blood pressure readings in emergency departments should not be readily attributed to pain or anxiety. Diagnosis must be based on meticulous follow-up and precise examinations.
Department of Emergency Medicine, Imam Hossein Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran.
Ali
A
Arhami Dolatabadi
Department of Emergency Medicine, Imam Hossein Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran.
Maryam
M
Motamedi
Safety Promotion and Injury Prevention Research Center, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran.
Hamidreza
H
Hatamabadi
Department of Emergency Medicine, Imam Hossein Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran.
Hossein
H
Alimohammadi
Blood Pressure; Emergency Department, Hospital; Hypertension; prevalence