Prevalence of Undiagnosed Hypertension in the Emergency Department

Background: Hypertension (HTN) is a serious health problem that threatens one fourth of the adult population in some countries. Objectives: This study aimed to assess the prevalence and outcome of undiagnosed hypertensive patients admitted to the emergency department. Materials and Methods: This cross-sectional study was conducted from March ۲۰۰۹ to March ۲۰۱۰ at Imam Hossein Medical and Educational Center, Teheran, Iran. A total of ۲۰۷۰ patients aged ۱۸ years and older were admitted to the emergency department without previous HTN history. Blood pressure was taken and repeated ۱۰ minutes later if initial systolic blood pressure ≥ ۱۴۰ mmHg or diastolic blood pressure ≥ ۹۰ mmHg. Those who matched the inclusion criteria entered the study for further follow-up. A numerical pain score was also used for pain intensity assessment. Chi-Square and Mann Whitney U tests were performed to compare differences between sex, age and education of the participants. Results: Based on the inclusion criteria, ۳۴۶ patients entered the study, out of which ۱۶۸ qualified for further evaluation and follow-up. Forty eight patients (۲۸.۶%) were finally diagnosed with high blood pressure. Our study showed that the prevalence of undiagnosed HTN was ۴.۸%. Significant differences between blood pressure, age, pain score and education level (P < ۰.۰۰۱) were found. This implies that old age, poor education and low pain score are positively associated with hypertension. Conclusions: Blood pressure readings in emergency departments should not be readily attributed to pain or anxiety. Diagnosis must be based on meticulous follow-up and precise examinations.