Template:Asymptomatic hypertension evaluation

Asymptomatic hypertension

  • Urine pregnancy in all women of child-bearing age (consider preeclampsia if positive)
Routine screening for acute target organ injury (e.g. creatinine, UA, ECG) is NOT required (Level C)[1]
In select patient populations, screening of creatinine may identify injury that affects disposition (Level C)[1]

Suggested algorithm:

  • <120 diastolic
    • No screening ED workup --> home with outpatient treatment
  • >210 systolic or >120-130 diastolic
    • Chem 7 (creatinine) --> home with outpatient treatment if no evidence of acute renal failure
      • "No other diagnostic screening tests (e.g. UA, ECG) appear to be useful"[1]
  • 1.0 1.1 1.2 Clinical Policy: Critical Issues in the Evaluation and Management of Adult Patients in the Emergency Department with Asymptomatic Elevated Blood Pressure. ACEP Clinical Policies Subcommittee on Asymptomatic Hypertension. Annals of Emergency Medicine. 2013; 62(1):59-63.