Correlation between subclinical heart disease and cardiovascular risk profiles in an urban emergency department population with elevated blood pressures: A pilot study

Heather M. Prendergast, Joseph Colla, Neal Patel, Marina Del Rios, Jared Marcucci, Ryan Scholz, Patience Ngwang, Katherine Cappitelli, Martha Daviglus, Samuel Dudley

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

Background Uncontrolled hypertension is a primary risk factor for development of cardiovascular complications. Objective Determine the point prevalence of left ventricular hypertrophy (LVH) and diastolic dysfunction in an urban emergency department (ED) population with elevated blood pressures (BP) and examine correlations between subclinical disease and patient cardiovascular risk profiles. Methods A convenience sample of patients with EBP (>140/90 on two measurements) had limited bedside echocardiograms (LBE). Subclinical hypertensive heart disease was classified as the presence of: LVH, abnormal ejection fraction (EF), or diastolic dysfunction. Results Thirty-nine patients with EBP were enrolled. The mean age was 46 years (SD = 10.9), 59% were women, 21% were smokers, and 92% had a history of hypertension. The average body mass index was 30.7 (SD = 8.7). Patients were 67% African American, 23% Latino, 5% Caucasian, 3% Asian, and 3% Native American. Subclinical disease was found in 39%: 31% had LVH, 15% had diastolic dysfunction, and 8% had abnormal EF. On bivariate analysis, elevated BP (p = 0.039) and blood urea nitrogen (p = 0.016) were correlated with subclinical heart disease. After adjusting for other covariates, receiving oral/intravenous antihypertensive medications in the ED (p = 0.005) was associated with subclinical heart disease. Conclusions We found a point prevalence of subclinical heart disease of 39% in this urban ED population, using LBE. Real-time identification of subclinical heart disease at early stages in the ED in conjunction with abnormal renal function can help emergency physicians identify those patients in need of more aggressive therapy and urgent follow-up.

Original languageEnglish (US)
Pages (from-to)756-761
Number of pages6
JournalJournal of Emergency Medicine
Volume48
Issue number6
DOIs
StatePublished - Jun 1 2015
Externally publishedYes

Bibliographical note

Funding Information:
The project described was supported by the National Center for Advancing Translational Sciences (Grant UL1TR000050 ), National Institutes of Health (NIH), through Grant UL1TR000050 . The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.

Keywords

  • elevated blood pressure
  • emergency department
  • emergency provider echocardiogram
  • subclinical heart disease

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