Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2015 Jun;48(6):756-61.
doi: 10.1016/j.jemermed.2014.12.026. Epub 2015 Mar 20.

Correlation between Subclinical Heart Disease and Cardiovascular Risk Profiles in an Urban Emergency Department Population with Elevated Blood Pressures: A Pilot Study

Heather M Prendergast  1 , Joseph Colla  1 , Neal Patel  1 , Marina Del Rios  1 , Jared Marcucci  1 , Ryan Scholz  1 , Patience Ngwang  1 , Katherine Cappitelli  1 , Martha Daviglus  2 , Samuel Dudley  3
Affiliations

Correlation between Subclinical Heart Disease and Cardiovascular Risk Profiles in an Urban Emergency Department Population with Elevated Blood Pressures: A Pilot Study

Heather M Prendergast et al. J Emerg Med. 2015 Jun.

Abstract

Background: Uncontrolled hypertension is a primary risk factor for development of cardiovascular complications.

Objective: Determine the point prevalence of left ventricular hypertrophy (LVH) and diastolic dysfunction in an urban emergency department (ED) population with elevated blood pressures (BP) and examine correlations between subclinical disease and patient cardiovascular risk profiles.

Methods: A convenience sample of patients with EBP (>140/90 on two measurements) had limited bedside echocardiograms (LBE). Subclinical hypertensive heart disease was classified as the presence of: LVH, abnormal ejection fraction (EF), or diastolic dysfunction.

Results: Thirty-nine patients with EBP were enrolled. The mean age was 46 years (SD = 10.9), 59% were women, 21% were smokers, and 92% had a history of hypertension. The average body mass index was 30.7 (SD = 8.7). Patients were 67% African American, 23% Latino, 5% Caucasian, 3% Asian, and 3% Native American. Subclinical disease was found in 39%: 31% had LVH, 15% had diastolic dysfunction, and 8% had abnormal EF. On bivariate analysis, elevated BP (p = 0.039) and blood urea nitrogen (p = 0.016) were correlated with subclinical heart disease. After adjusting for other covariates, receiving oral/intravenous antihypertensive medications in the ED (p = 0.005) was associated with subclinical heart disease.

Conclusions: We found a point prevalence of subclinical heart disease of 39% in this urban ED population, using LBE. Real-time identification of subclinical heart disease at early stages in the ED in conjunction with abnormal renal function can help emergency physicians identify those patients in need of more aggressive therapy and urgent follow-up.

Keywords: elevated blood pressure; emergency department; emergency provider echocardiogram; subclinical heart disease.

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interest: There are no conflicts of interest for any of the authors.

References

    1. Vinton DT, Capp R, Rooks SP, et al. Frequent users of US emergency departments: characteristics and opportunities for intervention. Emerg Med J. 2014 - PubMed
    1. Billings J, Raven MC. Dispelling an urban legend: frequent emergency department users have substantial burden of disease. Health Aff. 2013;32(12):2099–2108. - PMC - PubMed
    1. Baumann BM, Cline DM, Pimenta E. Treatment of hypertension in the emergency department. Journal of Am So Hypertension. 2011;5(5):366–377. - PubMed
    1. Levy PD, Cline D. Asymptomatic Hypertension in the Emergency Department: A Matter of Critical Public Health Importance. Acad Eme Med. 2009;16:1251–1257. - PubMed
    1. Rhodes KV, Gordon JA, Lowe RA for the Society of Academic Emergency Medicine Public Health and Education Task Force Preventive Services Work Group. Preventive care in the emergency department: part I: clinical preventive services—are they relevant to emergency medicine? Acad Emerg Med. 2000;7:1036–1041. - PubMed

Publication types

MeSH terms

Substances