Annals of Emergency Medicine
Volume 54, Issue 6 , Pages 791-792 , December 2009

Initiation of Therapy for Asymptomatic Hypertension in the Emergency Department

  • Katy Kinsella, MD
    • ,
  • Larry J. Baraff, MD

      Affiliations

    • Corresponding Author InformationAddress for correspondence: Larry J. Baraff, MD, UCLA Emergency Medicine Center, 924 Westwood Blvd., Suite 300, Los Angeles, CA 90024

References 

  1. Bernstein E, Goldfrank LR, Kellerman AL, et al. A public health approach to emergency medicine: preparing for the twenty-first century. Acad Emerg Med. 1994;1:277–286
  2. Chobabanian AV, Bakris GL, Black HR, et al. Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC7 report. JAMA. 2003;289:2560–2571
  3. Tanabe P, Persell S, Adams J, et al. Increased blood pressure in the emergency department: pain, anxiety, or undiagnosed hypertension?. Ann Emerg Med. 2008;51:221–229
  4. Dieterle T, Schuurmans MM, Strobel W, et al. Moderate-to-severe blood pressure elevation at ED entry (Hypertension or normotension?). Am J Emerg Med. 2005;23:474–479
  5. Vlcek M, Bur A, Woisetschlager C, et al. Association between hypertensive urgencies and subsequent cardiovascular events in patients with hypertension. J Hypertension. 2008;26:657–662
  6. Decker WW, Godwin SA, Hess EP, et al. Clinical policy: critical issues in the evaluation and management of adult patients with asymptomatic hypertension in the emergency department. Ann Emerg Med. 2006;47:237–249

 Funding and support: By Annals policy, all authors are required to disclose any and all commercial, financial, and other relationships in any way related to the subject of this article that might create any potential conflict of interest. The authors have stated that no such relationships exist. See the Manuscript Submission Agreement in this issue for examples of specific conflicts covered by this statement.

 Editor's note: Many patients present to the emergency department with elevated blood pressure that does not require emergent stabilization. While these patients may obtain substantial long-term benefit from therapy initiated in the emergency department, many clinicians withhold treatment under the belief that the optimal management of these patients lies beyond the capabilities of most emergency departments. In this installment of Clinical Controversies, “pro” and “con” advocates discuss opposing perspectives and present the available evidence and arguments that must be considered in deciding to initiate or withhold treatment in patients who present with non-emergent elevated blood pressure.

PII: S0196-0644(09)00484-3

doi: 10.1016/j.annemergmed.2009.05.001

Annals of Emergency Medicine
Volume 54, Issue 6 , Pages 791-792 , December 2009

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