Journal of the American Heart Association · 2025
High Burden of Markedly Elevated Blood Pressure Among Adults Presenting to a Community Emergency Department: An Analytical Cross-Sectional Study at a Teaching Hospital in Missouri, USA.
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Hlupeni Admire, Reiss Craig
Аннотация
BACKGROUND: Data on prevalence and risk factors for markedly elevated blood pressure (MEBP) (≥180/120 mm Hg) in community emergency departments (EDs) in the United States are limited.
METHODS: We conducted an analytical cross-sectional study to estimate MEBP prevalence and determinants at a community teaching hospital emergency department in the Midwest. Adults (≥18 years) presenting between January 1 and December 31, 2024 were included. Descriptive statistics summarized the data. Chi-square tests and logistic regression assessed associations. Variables with P<0.25 in bivariable analyses were entered into the multivariable model. Analyses were performed in Stata 18.
RESULTS: Of 41 676 individuals screened; 40 135 were included. MEBP prevalence was 6.93% (95% CI, 6.69-7.20; 2783/40135). Compared with patients without MEBP, those with MEBP were older (69.3 [17.5] versus 61.0 [21.1] years), more often insured (96.0% versus 94.2%) and with a primary care provider (84.8% versus 80.0%) but less likely to have had health care contact in the prior 3 months (21.4% versus 26.1%). They reported lower marijuana use (10.5% versus 13.7%) and had more comorbidities. In adjusted analyses, recent health care contact was associated with lower odds of MEBP (adjusted odds ratio [aOR], 0.66 [95% CI, 0.60-0.72]), whereas older age (aOR per additional year, 1.02 [95% CI, 1.02-1.02]), multimorbidity (aOR per additional comorbidity, 1.32 [95% CI, 1.20-1.45]), and Black race (aOR, 1.40 [95% CI, 1.24-1.58]) were associated with higher odds.
CONCLUSIONS: MEBP is common in community emergency departments and is more frequent among older adults, Black patients, and those with multimorbidity, but less common among those with recent health care contact.
METHODS: We conducted an analytical cross-sectional study to estimate MEBP prevalence and determinants at a community teaching hospital emergency department in the Midwest. Adults (≥18 years) presenting between January 1 and December 31, 2024 were included. Descriptive statistics summarized the data. Chi-square tests and logistic regression assessed associations. Variables with P<0.25 in bivariable analyses were entered into the multivariable model. Analyses were performed in Stata 18.
RESULTS: Of 41 676 individuals screened; 40 135 were included. MEBP prevalence was 6.93% (95% CI, 6.69-7.20; 2783/40135). Compared with patients without MEBP, those with MEBP were older (69.3 [17.5] versus 61.0 [21.1] years), more often insured (96.0% versus 94.2%) and with a primary care provider (84.8% versus 80.0%) but less likely to have had health care contact in the prior 3 months (21.4% versus 26.1%). They reported lower marijuana use (10.5% versus 13.7%) and had more comorbidities. In adjusted analyses, recent health care contact was associated with lower odds of MEBP (adjusted odds ratio [aOR], 0.66 [95% CI, 0.60-0.72]), whereas older age (aOR per additional year, 1.02 [95% CI, 1.02-1.02]), multimorbidity (aOR per additional comorbidity, 1.32 [95% CI, 1.20-1.45]), and Black race (aOR, 1.40 [95% CI, 1.24-1.58]) were associated with higher odds.
CONCLUSIONS: MEBP is common in community emergency departments and is more frequent among older adults, Black patients, and those with multimorbidity, but less common among those with recent health care contact.