{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,3]],"date-time":"2025-09-03T11:18:29Z","timestamp":1756898309309},"reference-count":12,"publisher":"Walter de Gruyter GmbH","issue":"9","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2013,9,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p id=\"P1_w2aab3b7c26b1b6b1aab1c16b1Aa\">\n                  <jats:bold>Context:<\/jats:bold> Hypertension is a common incidental finding in the emergency department (ED). However, the authors noticed a segment of patients who present to the ED specifically because their blood pressure is found to be elevated outside of the hospital. Emergency medicine physicians are often unsure of the level of intervention that is required for these patients.<\/jats:p>\n               <jats:p id=\"P2_w2aab3b7c26b1b6b1aab1c16b2Aa\">\n                  <jats:bold>Objective:<\/jats:bold> To determine if these patients have serious outcomes (ie, final diagnosis of myocardial infarction, angina, coronary syndrome, congestive heart failure, pulmonary edema, hypertensive encephalopathy, malignant hypertension, stroke, transient ischemic attack, subarachnoid hemorrhage, loss of vision, kidney failure, or aortic dissection) within 7 days of the initial ED visit.<\/jats:p>\n               <jats:p id=\"P3_w2aab3b7c26b1b6b1aab1c16b3Aa\">\n                  <jats:bold>Methods:<\/jats:bold> The authors retrospectively reviewed ED medical records from 2008 with a chief complaint of high blood pressure or hypertension in the physician or nursing notes. Age, sex, blood pressure, history of hypertension, associated symptoms, tests, medications, admission or discharge information, final diagnoses, and return visits within 7 days were recorded.<\/jats:p>\n               <jats:p id=\"P4_w2aab3b7c26b1b6b1aab1c16b4Aa\">\n                  <jats:bold>Results:<\/jats:bold> Of the 316 medical records that were reviewed, 149 met the study criteria and were included in analysis. Patient age range was 19 to 94 years (mean, 59.8 years; median, 61 years). Sixty patients (40%) were men and 89 (60%) were women. Of the 149 patients, 121 (81%) had a previous diagnosis of hypertension and 28 (19%) did not. Five patients (3%) had a normal initial blood pressure in the ED. Sixteen patients (11%) did not undergo diagnostic tests, and 77 patients (52%) received medication in the ED. Twenty-six patients (17%) were admitted to the hospital, and 123 (83%) were discharged or eloped. Four patients (2.7%; 95% confidence interval, 0.7-6.7) had a serious outcome noted within 7 days of initial presentation to the ED.<\/jats:p>\n               <jats:p id=\"P5_w2aab3b7c26b1b6b1aab1c16b5Aa\">\n                  <jats:bold>Conclusion:<\/jats:bold> Among patients presenting to the ED with a chief complaint of hypertension or high blood pressure and no serious associated complaint, the risk of serious outcome within 7 days is low.<\/jats:p>","DOI":"10.7556\/jaoa.2013.032","type":"journal-article","created":{"date-parts":[[2013,8,26]],"date-time":"2013-08-26T14:53:29Z","timestamp":1377528809000},"page":"664-668","source":"Crossref","is-referenced-by-count":6,"title":["Frequency of Serious Outcomes in Patients With Hypertension as a Chief Complaint in the Emergency Department"],"prefix":"10.1515","volume":"113","author":[{"given":"Steven P.","family":"Frei","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David B.","family":"Burmeister","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jesse F.","family":"Coil","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"374","published-online":{"date-parts":[[2013,9,1]]},"reference":[{"key":"2021040108243145168_j_jaoa.2013.032_ref_001_w2aab3b7c26b1b6b1ab2b2b1Aa","unstructured":"Centers for Disease Control and Prevention (CDC). Vital signs: prevalence, treatment, and control of hypertension\u2014United States, 1999-2002 and 2005-2008. MMWR Morb Mortal Wkly Rep.2011;60(4):103-108. http:\/\/www.cdc.gov\/mmwr\/preview\/mmwrhtml\/mm6004a4.htm. Accessed August 15, 2013."},{"key":"2021040108243145168_j_jaoa.2013.032_ref_002_w2aab3b7c26b1b6b1ab2b2b2Aa","unstructured":"ShaynePHPittsSR. Severely increased blood pressure in the emergency department. Ann Emerg Med.2003;41(4):513-529. http:\/\/www.ferne.org\/lectures\/ema_2007_pdfs\/htn_%20references\/ferne_htn_emerg_shayne_2003.pdf. Accessed February 11, 2013."},{"issue":"3","key":"2021040108243145168_j_jaoa.2013.032_ref_003_w2aab3b7c26b1b6b1ab2b2b3Aa","doi-asserted-by":"crossref","first-page":"230","DOI":"10.1016\/j.annemergmed.2005.11.001","article-title":"Evaluation and treatment of patients with severely elevated blood pressure in academic emergency departments: a multicenter study","volume":"47","author":"Karras","year":"2006","journal-title":"Ann Emerg Med."},{"key":"2021040108243145168_j_jaoa.2013.032_ref_004_w2aab3b7c26b1b6b1ab2b2b4Aa","unstructured":"BenderSRFongMWHeitzSBisognanoJD. Characteristics and management of patients presenting to the emergency department with hypertensive urgency. J Clin Hypertens (Greenwich). 2006;8(1):12-18. http:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/j.1524-6175.2005.04898.x\/pdf. Accessed February 8, 2013."},{"issue":"4","key":"2021040108243145168_j_jaoa.2013.032_ref_005_w2aab3b7c26b1b6b1ab2b2b5Aa","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1038\/sj.jhh.1000796","article-title":"Clinical presentation and management of patients with uncontrolled, severe hypertension: results from a public teaching hospital","volume":"13","author":"Preston","year":"1999","journal-title":"J Hum Hypertens."},{"issue":"2","key":"2021040108243145168_j_jaoa.2013.032_ref_006_w2aab3b7c26b1b6b1ab2b2b6Aa","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1016\/j.ajem.2008.11.015","article-title":"Routine testing in patients with asymptomatic elevated blood pressure in the ED","volume":"28","author":"Nishijima","year":"2010","journal-title":"Am J Emerg Med."},{"issue":"5","key":"2021040108243145168_j_jaoa.2013.032_ref_007_w2aab3b7c26b1b6b1ab2b2b7Aa","doi-asserted-by":"crossref","first-page":"366","DOI":"10.1016\/j.jash.2011.05.002","article-title":"Treatment of hypertension in the emergency department","volume":"5","author":"Baumann","year":"2011","journal-title":"J Am Soc Hypertens."},{"key":"2021040108243145168_j_jaoa.2013.032_ref_008_w2aab3b7c26b1b6b1ab2b2b8Aa","unstructured":"KarrasDJUfbergJWHeilpernKL. Elevated blood pressure in urban emergency department patients. Acad Emerg Med.2005;12(9):835-843. http:\/\/onlinelibrary.wiley.com\/doi\/10.1197\/j.aem.2005.04.015\/pdf. Accessed February 8, 2013."},{"key":"2021040108243145168_j_jaoa.2013.032_ref_009_w2aab3b7c26b1b6b1ab2b2b9Aa","doi-asserted-by":"crossref","unstructured":"BaumannBMAbateNLCowanRMChanskyMERosaKBoudreauxED. Characteristics and referral of emergency department patients with elevated blood pressure. Acad Emerg Med.2007;14(9):779-784. http:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/j.1553-2712.2007.tb02351.x\/pdf. 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