If your blood
pressure goes up, but you are feeling fine, chances are you will still rush to
the nearest hospital emergency room, which, according to a recent study, might
be a wrong move.
Visits to emergency
departments for patients with hypertension increased by 64 percent between 2002
and 2012 while hospitalizations for those visits declined by 28 percent.
The research from the
Institute for Clinical Evaluative Sciences in Toronto suggests that aggressive
home monitoring of blood pressure may be driving patients to emergency
departments despite the lack of other emergency conditions, such as stroke.
"We encourage
patients to monitor their blood pressure at home if they have been diagnosed
with hypertension, but not every high blood pressure reading is an emergency,"
said lead study author Clare Atzema.
Atzema added,
"Some of the increase in emergency visits is due to the aging of our
population, but we suspect that recent public education campaigns recommending
home blood pressure monitoring may have inadvertently contributed to the rise
in visits for hypertension."
During the study
period in which visits to Ontario emergency departments for hypertension
increased from 15,793 to 25,950 per year, the proportion of patients admitted
to the hospital as a result decreased from 9.9 percent to 7.1 percent. Among
the patients whose emergency department visit ended in admission to the
hospital, the most frequent hospital diagnoses were stroke, renal failure and
heart failure. The proportion of patients arriving via ambulance increased over
time, from 10.7 percent to 14.3 percent.
Mortality was very
low: less than 1 percent of patients died within 90 days and only 4.1 percent
died within 2 years. Together, hospitalizations for stroke, heart failure,
acute myocardial infarction, atrial fibrillation, renal failure, hypertensive
encephalopathy and aortic dissection were less than 1 percent at 30 days.
"Stroke remains
a huge killer and we do appreciate patients with hypertension being so conscientious about
monitoring their readings," noted Atzema, adding "Patients should be
aware that unless their high blood
pressure coincides
with symptoms of a medical emergency, such as chest pain, severe headache,
nausea or shortness of breath, they probably do not need to visit the ER. We of
course encourage them to follow up as soon as possible with their regular
physician. If there is any doubt, come to the emergency department: we would
rather have you come without an emergency than stay home with one."
The study appears in
journal Annals of Emergency Medicine.
Representative
Image
Source: ANI
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