Screening for hypertension in the emergency department

Objective: A study was undertaken to answer the question: "For those ambulatory patients who attend the emergency department, does routinely measuring their blood pressure and providing written information about hypertension and advising them to see their general practitioner if indicated, compared with no measurement or advice, lead to subsequent interventions ( drug therapy, life style advice) to control blood pressure?'' Method: A randomised controlled trial was performed in 400 patients attending the emergency department of Southampton General Hospital, a large UK teaching hospital serving a mainly urban population. Patients were randomised to the intervention and control groups. Outcome measure: New drug treatment for hypertension at follow-up at 3 and 6 months. Results: No new antihypertensive drug treatment was started for any of the participants ( n= 377) in the trial. Conclusion: Although screening was successfully completed, no differences were seen between the intervention and control groups. The high level of blood pressure screening within primary care became evident as the trial progressed. This, combined with the fact that the trial was limited to patients registered with a general practitioner, possible expectation bias in control subjects and poor compliance with follow-up instructions, may explain the result.