asymptomatic hypertension

4 Nov

good review of the ACEP Clinical Policy in October’s ACEP News mag:

 

SOME HIGHLIGHTS:

all recommendations are Level C (little to no great evidence, but some consensus among the policy committee)

 

“In ED patients with asymptomatic markedly elevated blood pressure, routine screening for acute target organ injury (e.g, serum creatinine, urinalysis, ECG) is not required.”

 

renal dysfunction of unknown immediate clinical significance could be detected in a small number of patients (up to 5%) by checking a serum creatinine. (study not highly applicable to the ED crowd)

 

Other screening, including the urinalysis, chest radiograph, and electrocardiogram were shown to be of no benefit.

 

In patients with asymptomatic markedly elevated blood pressure, routine ED medical intervention is not required.

 

In select patient populations (e.g, poor follow-up), emergency physicians may treat markedly elevated blood pressure in the ED and/or initiate therapy for long-term control. (and refer for outpatient follow-up)

 

References: acep article; picture

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