P-447 Managing High Blood Pressure In The Emergency Department In Primary Health Care

Zografou I. (Palaiochori), Liveris A. (Palaiochori), Papadopoulou D. (Xanthi), Doukelis P. (Thessaloniki), Tsialios I. (Corfu), Sambanis C. (Thessaloniki)
Background/aim: Hypertensive emergency is a condition marked by elevated systolic and diastolic blood pressure (BP) along with an acute target organ damage. Hypertensive urgency is a condition with elevated BP and absence of an acute organ damage. Our aim was to record the epidemiological data and medical history of the patients who presented in the Emergency department complaining of high BP, as well as the management provided by doctors for this condition.
Design/methods: We studied the records of patients who received consultation after complaining for a high BP in the Health Centre between October 2007 and October 2008. These accounted for 56 (0.73%) from 7653 visits totally (37 males and 19 females). The BP measurements they presented ranged from 140–250 mm Hg for systolic and 80–140 for diastolic BP. For each individual, we recorded the systolic and diastolic BP, the presence of concomitant signs or symptoms, the history, the anti-hypertensive medication being taken and the doctor’s treatment upon the visit.
Results: The commonest concomitant manifestations were from cardiovascular and nervous systems. 53 patients (94.60%) had already been under treatment for hypertension. In 47 (83.92%) of the cases, doctors intervened with administration of pressure lowering drugs, such as ACE inhibitors, diuretics, calcium channel blockers and in 6 (10.71%) with anti-anxiety drugs. No use of sublingual administration of nifedipine was made. Immediate reference to a Hospital took place in 1 case due to suspected malignant hypertension.
Conclusion: Although a peak of BP doesn’t necessarily require urgent treatment, doctors often use drugs in order to lower a remarkably high BP, giving in to patients’ appeals and/or to their insecurity for an acute complication.
Managing high blood pressure in the emergency department in primary health care