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Published by American College of Emergency Physicians (ACEP) · Class of Evidence framework
Approximately half of adults in the US are affected by hypertension, and there is wide variation in practice patterns among emergency physicians for managing asymptomatic elevated blood pressure. This clinical policy updates the 2013 ACEP policy by incorporating new evidence to guide emergency physicians on whether initiating antihypertensive medications at ED discharge is safe and effective.
Key Takeaways
Updates the 2013 clinical policy by incorporating new evidence that demonstrates the efficacy and safety of initiating antihypertensive medications from the ED. The previous policy discouraged routine intervention. This update does not revisit screening for target organ injury or the need for acute blood pressure lowering within the ED.
Consider the initiation of outpatient antihypertensive medications for patients being discharged from the ED with asymptomatic elevated blood pressure.
Patients with asymptomatic elevated blood pressure should be referred for outpatient follow-up.
Clinical Topic
Asymptomatic Elevated Blood Pressure
Objectives
To determine if initiation of outpatient antihypertensive medications from the emergency department is safe and effective for adult patients being discharged with asymptomatic elevated blood pressure.
Target Patient Population
Adult emergency department patients presenting with asymptomatic elevated blood pressure without signs and symptoms of acute target organ injury.
Diagnostic Criteria
Hypertension is defined as blood pressure more than 130/80 mmHg.
Target Providers
Therapeutic Area
Cardiovascular DiseaseGuideline Scope
Inclusion Criteria
Exclusion Criteria
Care Settings
System: Class of Evidence framework
Evidence Distribution
Evidence Levels
Recommendation Strength
Monitoring Guidance
Patients with asymptomatic elevated blood pressure should be referred for outpatient follow-up.
Difficulty
advanced
Learning Paths