Recognition of Asymptomatic Hypertension in an Urban Emergency Department: Where Are We Now?
Kimberly Souffront, Christina Gestal, Gail DʼEramo Melkus and 1 others
PMID 27792074WHAT IT FOUND
Only 4.6% of emergency department patients with asymptomatic high blood pressure were referred for follow-up, despite half having their pressure reassessed.
Referred patients were more likely to be middle-aged and have no prior heart disease history.
Key findings
01Referral rates for asymptomatic hypertension in the ED remain extremely low, with only 4.6% of eligible patients receiving documented follow-up instructions.
02Patients without previously documented cardiovascular disease and those who were middle-aged were significantly more likely to be referred for follow-up.
03Of the small number of patients who were referred, 100% adhered to the recommendation and sought follow-up care at the facility.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study is a retrospective chart review, which relies on documentation quality and cannot capture undocumented clinical reasoning or verbal referrals. The sample was drawn from only two urban academic centers in New York City, which may not reflect practices in rural or community hospitals. The number of referred patients was very small (n=28), limiting the generalizability of the findings regarding referral predictors and adherence.
Declared interests
No specific conflicts of interest or funding sources were declared in the provided text.
The easy way to misread this
Do not interpret the 100% adherence rate among referred patients as evidence that referral strategies are universally effective or that the current system is working. This figure is based on only 28 patients, a tiny fraction of the 1,184 eligible, so it reflects the behavior of a highly selected group rather than the population at large.