Prevalence of neurological complaints among emergency department patients with severe hypertension

Hypertension is a leading cause of cardiovascular disease and premature death worldwide as well as a major risk factor for stroke [1,2]. The prevalence of hypertension is substantial with nearly half of US adults (47% or 116 million people) diagnosed with hypertension based on measured blood pressure (BP) values or prescription of anti-hypertensive medications [1,3]. Unsurprisingly, elevated BP is common among emergency department (ED) patients and the proportion of ED visits for hypertensive emergencies has increased monotonically in the US [4,5].

The brain is one potential organ that can be damaged by acute severe hypertension [6]. Additionally, acute cerebrovascular events are themselves associated with BP elevations [7,8]. Diagnosing acute vascular brain injury either as a consequence of or a reason for severe hypertension can be challenging given the variety of potential neurological manifestations of cerebrovascular disease ranging from encephalopathy to minor, transient, and non-specific neurological deficits [[9], [10], [11]].

Our work therefore aims to determine the prevalence and types of neurological complaints reported among US ED patients with severe hypertension using population-level data. To further understand current care practices for these ED patients with severely elevated BP, we also detail their demographic, clinical, management, and disposition characteristics comparing those presenting with versus without neurological complaints.

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