A new study finds that home blood pressure monitoring is leading more and more people to emergency rooms when true emergency symptoms aren't present.
Published in the Annals of Emergency Medicine, the study analyzed more than 200,000 emergency room visits at 180 locations. From 2002 to 2012, there was a 64 percent increase in emergency visits for hypertension. However, over the same time period, hospitalizations for the same reason declined.
"We encourage patients to monitor their blood pressure at home if they have been diagnosed with hypertension, but not every high blood pressure reading is an emergency," lead author Dr. Clare Atzema said. "Some of the increase in emergency visits is due to the aging of our population, but we suspect that recent public education campaigns recommending home blood pressure monitoring may have inadvertently contributed to the rise in visits for hypertension."
Atzema and her research team found the number of annual visits to ERs for hypertension increased from 15,793 to 25,950. However, the number of patients admitted for hypertension decreased from 9.9 percent to 7.1 percent, which suggests not every person whose blood pressure is high should seek emergency treatment.
Additionally, Atzema noted that mortality incidences were quite low for hypertension-related cases. Less than 1 percent of patients died within 90 days of going to an emergency room for hypertension, and 4.1 percent died within two years of the visit. Other findings include:
- Most patients who were admitted to the hospital after a complaint of hypertension in the ER were ultimately admitted for renal failure, heart failure or stroke.
- People who live in the lowest-income neighborhoods accounted for nearly a quarter of all 2012 hospital ER visits for hypertension. Residents from higher-income neighborhoods made up 16.4 percent of visits.
Researchers say patients should seek emergency treatment if a high blood pressure reading comes along with other symptoms.
For example, unless high blood pressure coincides with chest pain, a severe headache, nausea or shortness of breath, there's probably no need to go to an ER, Atzema said.
"Stroke remains a huge killer, and we do appreciate patients with hypertension being so conscientious about monitoring their readings," Atzema told ScienceDaily. "We of course encourage (patients) to follow up as soon as possible with their regular physician. If there is any doubt, come to the emergency department. We would rather have you come without an emergency than stay home with one."
The data can also demonstrate the value of digital remote patient monitoring that many health systems are initiating. Patients wirelessly submit health data to a dashboard where a doctor or nurse reviews it. If there's a problem that needs medical attention, the patient is notified. Otherwise, patients who use these types of services probably aren't as likely to seek emergency care.
More education is needed to help patient better intepret the readings they see on home blood pressure monitors, Atzema told The Globe and Mail.
"People don't know what to do with the numbers," said Atzema, who is also a scientist at the Institute for Clinical Evaluative Sciences. "People don't understand how variable blood pressure can be."
