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Hypertensive Management in Asymptomatic Patients: Do No Harm

This resource discusses the initiation of medical management based on blood pressure levels, accuracy of BP measurements for screening, benefits of acute BP reduction, ACEP recommendations, and future research areas in managing asymptomatic hypertension.

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Hypertensive Management in Asymptomatic Patients: Do No Harm

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  1. Hypertensive Management in the Asymptomatic Patient: First do no harm Steven A Godwin MD, FACEP University of Florida, COM-Jacksonville Ponte Vedra 2007

  2. Question #1 • Initiation of medical management is recommended at which level of BP? • 120/75 • 140/90 • 135/80 • 160/100

  3. Question 2 • Are blood pressure measurements accurate for screening for asymptomatic hypertension in the ED? • Yes • No

  4. ACEP Recommendations • Are ED BP readings accurate and reliable for screening asymptomatic patients for HTN? • Level B - If 2 or more measurements are elevated with a SBP > 140 mmHg or DBP > 90 mmHg, the patient should be referred for follow-up for possible HTN and appropriate BP management • Level C – Pts with 1 elevated BP reading may require further screening in the outpt setting

  5. Is there Benefit with Acute Blood Pressure Reduction in Asymptomatic Patients? • Beyond making us feel better?!

  6. ACEP Recs for Asymptomatic HTN • Level B- (1) Rapidly lowering BP is unnecessary and may be harmful in some pts. (2) Initiating treatment is not necessary when definitive follow-up is available (3) When ED treatment is initiated, BP should be lowered gradually and should not be expected to normalize in the ED

  7. Future Areas of Research • What is the acute work-up for asymptomatic hypertension in the ED? • Some limited studies ferne_pv_2007_htn_godwin_062307_finalcd

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