ER Visits for High Blood Pressure Jumped

Hypertension deaths in hospital declined

(RxWiki News) About 1 in 3 Americans has high blood pressure. Although medicine and lifestyle changes can help, a rise in emergency care for blood pressure suggests that many may not have it under control.

Heart disease is the leading cause of death in the US, according to the Centers for Disease Control and Prevention. A major risk factor for stroke, heart attack and heart failure is hypertension (high blood pressure).

High blood pressure can often be reduced through exercise, diet and taking appropriate medications. A new study, however, suggests that people may not be managing their blood pressure well. The research found that emergency room visits for high blood pressure increased during a four-year span.

"Seek treatment for high blood pressure."

In an interview with dailyRx News, Sarah Samaan, MD, explained why high blood pressure would require emergency treatment.

"Blood pressure at levels over 180/110 poses an immediate risk for stroke and raises the risk for heart attack, heart failure, and kidney failure," said Dr. Samaan. "Because levels this high can be so dangerous, it is important to get the blood pressure down quickly and safely. That is why it's advisable to go to the ER if your home readings are in this danger zone."

Sourabh Aggarwal, MD, chief resident in the Department of Internal Medicine at Western Michigan University School of Medicine in Kalamazoo, co-wrote this new study with Vishal Gupta, MD, a cardiologist. The study was presented Sept. 9 at the American Heart Association’s High Blood Pressure Research Scientific Sessions 2014.

The doctors reviewed data on about 3.9 million ER visits between 2006 and 2011. Hypertension was the first listed diagnosis for each of these visits.

Blood pressure at 180/110 millimeters of mercury (mm Hg) is at crisis level. The American Heart Association (AHA) recommends going to the ER when hypertension gets this high. The AHA says that normal blood pressure is below 120/80 mm Hg.

The study authors found that ER visits for essential hypertension increased from 190.1 visits per 100,000 people in 2006 to 238.5 visits per 100,000 in 2011. Essential hypertension is high blood pressure with no known cause.

Also, ER visits of patients with secondary hypertension rose by 19 percent in that time frame. Secondary hypertension is blood pressure that shoots up because of an identifiable cause. The cause may be kidney disease, for example.

"This shows we are not doing a good job in controlling high blood pressure [outside the hospital]," said Dr. Aggarwal in a statement.

"There are a number of reasons ER visits may be increasing," said Dr. Samaan, who was not involved in this study.

"The more optimistic view is that perhaps because home blood pressure machines are so accessible, people are becoming more aware of their readings, and taking it more seriously when the blood pressure is out of range," she said. "On the negative side, hypertension is a growing problem, directly related to obesity and a diet based on salty processed foods and restaurant meals. This not only creates more cases of hypertension, but also makes it more difficult to treat people who already have the condition, since many times multiple medications are required."

ER treatment of high blood pressure, however, appears to have improved over time.

Hospital admissions of patients with essential high blood pressure dropped by 15 percent from 2006 to 2011. Admission of those with secondary hypertension declined by 12 percent.

Among the studied patients, the in-hospital death rate fell by 36 percent.

“The decreasing in-hospital mortality rate points to improving care of hospitalized patients,” the authors wrote.

Studies presented at conferences have not necessarily been peer-reviewed. The study authors disclosed no conflicts of interest.

Review Date: 
September 9, 2014