Emergency department (ED)-based screening and referral of patients with elevated blood pressure (BP) are recommended by 2006 and 2013 American College of Emergency Physicians guidelines; however, it is unknown if these recommendations or disparities in care impact clinical practice. The objectives of the study were to assess temporal trends in antihypertensive prescriptions, outpatient follow-up referrals, and diagnosis of hypertension (HTN)/elevated BP and to identify potential disparities by patient characteristics. Using the 2005–2015 National Hospital Ambulatory Medical Care Survey, we examined the frequency and trends over time of antihypertensive prescriptions, outpatient follow-up referrals, and BP diagnoses for US ED visits by adult patients with an elevated triage BP and identified potential disparities in management by patient demography and socioeconomic status. Of the 594 million eligible ED visits by patients from 2005 to 2015, 1.2% (1.0%–1.4%) received antihypertensive prescriptions at discharge, 82.3% (80.0%–83.6%) outpatient follow-up referrals, and 2.1% (1.9%–2.4%) an HTN/elevated BP diagnosis. There were small annual increases over time in the odds of antihypertensive prescriptions at discharge (adjusted odds ratio [aOR] 1.05 [1.00–1.10]), follow-up referrals (aOR 1.04 [1.01–1.07]), and HTN/elevated BP diagnosis (aOR 1.05 [1.02–1.08]). For BPs ≥160/100 mm Hg, prescriptions were more common for Blacks (aOR 2.36 [1.93, 2.88]) and uninsured patients (aOR 1.81 [1.38, 2.38]), and diagnoses were more common for Blacks (aOR 1.95 [1.70, 2.24]) and uninsured patients (aOR 1.30 [1.09, 1.55]). These data suggest little change in and the need for improvement in the management of ED patients with elevated BP, despite the American College of Emergency Physicians guidelines, and raise concern about patient care disparities.

2006 年和 2013 年美国急诊医师学会指南建议对高血压 (BP) 患者进行基于急诊科 (ED) 的筛查和转诊；然而，尚不清楚这些建议或护理差异是否会影响临床实践。该研究的目的是评估抗高血压处方、门诊随访转诊和高血压 (HTN)/血压升高的诊断的时间趋势，并根据患者特征确定潜在差异。利用 2005-2015 年全国医院门诊医疗调查，我们研究了分诊血压升高的成年患者在美国急诊室就诊时的抗高血压处方、门诊随访转诊和血压诊断的频率和趋势。根据患者人口统计和社会经济状况进行管理。 2005年至2015年，在符合条件的5.94亿名急诊就诊患者中，1.2%（1.0%–1.4%）在出院时接受了抗高血压处方，82.3%（80.0%–83.6%）门诊随访转诊，2.1%（1.9%） –2.4%) 高血压/血压升高的诊断。随着时间的推移，出院时服用抗高血压处方的几率（调整后的比值比 [aOR] 1.05 [1.00–1.10]）、随访转诊（aOR 1.04 [1.01–1.07]）和高血压/血压升高诊断的几率每年都有小幅增加（aOR 1.05 [1.02–1.08]）。对于血压≥160/100 mm Hg，黑人（aOR 2.36 [1.93, 2.88]）和未投保患者（aOR 1.81 [1.38, 2.38]）开处方更常见，黑人诊断更常见（aOR 1.95 [1.70， 2.24]）和未投保患者（aOR 1.30 [1.09，1.55]）。 这些数据表明，尽管有美国急诊医师学会的指导方针，但血压升高的急诊科患者的治疗几乎没有变化，而且需要改进，并引起了对患者护理差异的担忧。