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Asymptomatic Hypertension (2013)

  • Inclusion:
    • Age ≥ 18
    • Symptomatic elevated BP
    • Lack signs of symptoms of acute target organ injury.
  • Exclusion:
    • Acute hypertensive emergencies (acute stroke, cardiac ischemia, pulmonary edema, encephalopathy, CHF)
    • Pregnant
    • ESRD
    • Emergent conditions that are likely to cause elevated BP not directly related to acute target organ injury
    • Acute presentation of serious medical conditions associated with hypertension (stroke, MI, CHF)
  • Level A: None
  • Level B: None
  • Level C:
    • Routine screening for acute target organ injury (Cr, UA, ECG) not required
    • In select patient population ( poor follow up), screening creatinine may identify kidney injury that affects disposition.
    • Routine ED medical intervention not required.
    • May treat elevated BP in ED +/or initiate therapy for long term control in select patients.
    • Refer for outpatient follow up.

Clinical Policy: Critical issues in the evaluation and management of adult patients in the emergency department with asymptomatic elevated blood pressure. Ann Emerg Med. 2013;62:59-68.

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