Barriers to screening and intervention for ED patients at risk for undiagnosed or uncontrolled hypertension.

Objectives: We describe clinician-reported knowledge of the Joint National Committee (JNC7) on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure definitions of Stage I hypertension; perceived causes of elevated blood pressure; barriers to blood pressure re-assessment; risk of adverse events associated with the elevated blood pressure.

Methods: Health care providers from five emergency departments completed a questionnaire assessing knowledge of blood pressure criteria for hypertension, perceived causes of elevated blood pressures, barriers to re-assessment, and perceived risk of an adverse event at one year in a patient within three defined systolic and diastolic blood pressure ranges. Descriptive statistics were used to analyze the data.

Evaluation, management, and referral of elderly emergency department patients with elevated blood pressure.

Objectives: To determine blood pressure (BP) reassessment rates and to describe the evaluation and outpatient referral rates of elderly emergency department (ED) patients with elevated BP.

Methods: This was a retrospective cohort of patients who were at least 60 years, presented with a systolic BP of at least 140 mmHg or diastolic BP at least 90 mmHg, and were discharged from the ED. BP measurements, ancillary testing, and discharge instructions were obtained from a random selection of medical records.

Provider self-report and practice: reassessment and referral of emergency department patients with elevated blood pressure.

Background: We attempted to identify patient factors associated with blood pressure (BP) reassessment and to compare health-care provider self-reported reassessment and referral to actual practice in an emergency department (ED) setting.

Methods: Provider reassessment and referral practices were determined through systematic review of 1,250 medical records at five EDs. Medical records were included if patients were > or =18 years, nonpregnant, presented with a systolic (SBP) > or =140 or diastolic BP (DBP) > or =90 mm Hg, and discharged.

Knowledge translation of the American College of Emergency Physicians clinical policy on hypertension.

Objectives: To determine if dissemination of the American College of Emergency Physicians clinical policy on hypertension to emergency physicians would lead to improvements in blood pressure reassessment and referral of emergency department (ED) patients with elevated blood pressure.

Methods: Two academic centers implemented a pre-post intervention design, with independent samples at pre and post phases. ED staff were blinded to the investigation.