Goldberg Elizabeth M, Wilson Taneisha, Jambhekar Bianca, Marks Sarah J, Boyajian Michael, Merchant Roland C
Department of Emergency Medicine, Brown University, 55 Claverick Street, Providence, RI, 02903, USA.
Department of Health Services, Policy, and Practice, Brown University School of Public Health, Providence, RI, USA.
High Blood Press Cardiovasc Prev. 2019 Feb;26(1):45-53. doi: 10.1007/s40292-019-00300-0. Epub 2019 Jan 19.
Emergency departments (EDs) are critical sites for hypertension (HTN) screening. Home blood pressure (BP) monitoring (HBPM) is used routinely in outpatient settings, yet its utility after the ED visit for those with elevated BP in the ED is unclear.
In this pilot study, we assessed if HBPM could detect HTN in patients with elevated in-ED BP.
From September 2014 to July 2017, we recruited adult patients at an urban, academic ED with a triage BP ≥ 120/80 mmHg and no history of HTN into this prospective cohort observational study. After their ED visit, participants obtained BP measurements for two weeks using a validated HBPM. HTN was considered probable if the average HBPM BP was ≥ 135/85 mmHg. We calculated the proportion of participants whose ED BP measurement accurately predicted HTN using HBPM after discharge.
Of 136 participants enrolled, 93 (68%) returned the HBPM with at least four home BP measurements [mean number of measurements obtained: 29 (SD: 17, range 4-59)]. Participants' median age was 40 years-old (IQR 34-48); 55% were female, 19% were black, and 58% were white. Forty-six percent of participants with elevated in-ED BP had HTN in follow-up.
For patients with elevated BP in the ED, HBPM could be valuable for determining which patients have HTN and require expedient follow-up.
急诊科是高血压（HTN）筛查的关键场所。家庭血压（BP）监测（HBPM）在门诊环境中常规使用，但对于急诊科血压升高的患者，急诊就诊后其效用尚不清楚。
在这项试点研究中，我们评估了HBPM能否检测出急诊科血压升高患者的高血压。
从2014年9月至2017年7月，我们在一家城市学术急诊科招募了分诊血压≥120/80 mmHg且无高血压病史的成年患者，纳入这项前瞻性队列观察性研究。急诊就诊后，参与者使用经过验证的HBPM进行了两周的血压测量。如果平均HBPM血压≥135/85 mmHg，则认为可能患有高血压。我们计算了出院后使用HBPM进行急诊血压测量能准确预测高血压的参与者比例。
在136名登记参与者中，93名（68%）返回了HBPM，且至少有四次家庭血压测量值[获得的测量值平均数：29（标准差：17，范围4 - 59）]。参与者的年龄中位数为40岁（四分位距34 - 48）；55%为女性，19%为黑人，58%为白人。急诊科血压升高的参与者中有46%在随访中患有高血压。
对于急诊科血压升高的患者，HBPM对于确定哪些患者患有高血压并需要及时随访可能具有重要价值。
