Evaluation of the emergency department as a site for hypertension screening.

To see if the emergency department is an appropriate site for hypertension screening, the coverage, appropriateness of the target population and the adequacy of follow-up procedures were evaluated. The study was conducted in the Adult Emergency Department of The Johns Hopkins Hospital, which 61% of the community regard as their regular source of care. All patients had their blood pressure read in the emergency department. A reading of 95 diastolic or greater was used as the definition of hypertension. Data from the 1970 census and The Johns Hopkins outpatient department billing system were used to evaluate screening coverage. Data to judge the appropriateness of the target population and adequacy of follow-up were collected in a retrospective audit of a random sample of emergency department records. The overall prevalence rate of hypertensive blood pressure reading was 19.5%. Blood pressure was read in only 75% of sample cases. The potential screeining coverage ranged from 9.9% to 38.6% with an overall community coverage of 24.2%. Less than 10% of the detected hypertensives were referred for follow-up. Therefore, in some emergency departments, including the Adult Emergency Department of The Johns Hopkins Hospital, hypertension screening may be feasible.