Journal article
Screening for hypertension using emergency department blood pressure measurements can identify patients with undiagnosed hypertension: A systematic review with meta‐analysis
- Abstract:
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Hypertension is the leading risk factor for death globally. A significant percentage of patients admitted to hospital have undiagnosed hypertension, yet recognition of elevated blood pressure (BP) in hospital and referral for post‐discharge assessment are poor. Physician perception that elevated inhospital BP is attributable to anxiety, pain, or white coat syndrome may underlie an expectation that BP will normalize following discharge. However, these patients frequently remain hypertensive. The authors conducted a systematic review to evaluate the extent to which elevated inhospital BP can predict the presence of hypertension in previously undiagnosed adults. The authors included cohort studies in which hospital patients whose BP exceeded the study threshold underwent further post‐discharge BP assessment following discharge. Twelve studies were identified as eligible for inclusion; a total of 2627 participants met review eligibility criteria, and follow‐up BP data were available for 1240 (47.2%). Median percentage of patients remaining hypertensive following discharge was 43.6% (range: 14.2‐76.5). Across 7 studies which identified people with possible hypertension using an index test threshold of 140/90, the pooled proportion subsequently identified with hypertension at follow‐up was 43.4% (95% CI: 25.1%‐61.8%). This review indicates that screening for hypertension in the emergency hospital environment consistently identifies groups of patients with undiagnosed hypertension. Unscheduled hospital attendance therefore offers an important public health opportunity to identify patients with undiagnosed hypertension.
- Publication status:
- Published
- Peer review status:
- Peer reviewed
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(Preview, Version of record, pdf, 498.9KB, Terms of use)
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- Publisher copy:
- 10.1111/jch.13643
Authors
- Publisher:
- Wiley
- Journal:
- Journal of Clinical Hypertension More from this journal
- Volume:
- 21
- Issue:
- 9
- Pages:
- 1415-1425
- Publication date:
- 2019-08-06
- Acceptance date:
- 2019-06-18
- DOI:
- EISSN:
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1751-7176
- ISSN:
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1524-6175
- Keywords:
- Pubs id:
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pubs:1017268
- UUID:
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uuid:e607a0bb-41cb-4a96-a765-1b04524ad130
- Local pid:
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pubs:1017268
- Source identifiers:
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1017268
- Deposit date:
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2019-06-18
Terms of use
- Copyright holder:
- Armitage et al
- Copyright date:
- 2019
- Notes:
- © The Authors. The Journal of Clinical Hypertension published by Wiley Periodicals, Inc. This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial‐NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
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