When the Patient's Only Complaint Is a Scary Number

To examine outcomes of emergency department (ED) visits for high blood pressure (BP), investigators in Ontario, Canada, studied the records of 1508 ED visits from 2010 to 2011 with a primary diagnosis of hypertension and 500 visits with a diagnosis of “a complication of hypertension, such as stroke.”

Median blood pressure among patients with a primary diagnosis of hypertension was 182/97 mm Hg. Among patients with this primary diagnosis who visited the ED only because of a numerically elevated BP measured in a pharmacy or at home, 3% were admitted. In contrast, among patients with this primary diagnosis who were referred to the ED by a physician, 12% were admitted. From this contrast, the authors conclude that self-referral for isolated hype…