An ‘Incidental’ Finding May Be Far More Threatening Than the Presenting Complaint

Patients are unlikely to seek ongoing care for high blood pressure at their closest urgent care center. That doesn’t mean it won’t be first identified there, though. And depending on the patient’s age and life expectancy, your ability to flag which patient’s hypertension needs attention and who wouldn’t benefit from treatment could mean a significant difference in the outcome. According to an article just published by JAMA Internal Medicine, intensive treatment for hypertension “may be appropriate for some adults with hypertension aged 60 years and older with a life expectancy of greater than 3 years but may not be suitable for those with less than 1 year” of life expectancy. More specifically, 19.1 months of intensive treatment were needed to avoid a single cardiovascular event in those patients. It all boils down to the patient’s risk profile and the potential harm of the therapy; patients expected to live more than 3 years from the time the hypertension is identified would be more likely to derive benefit that outweighs the risk of the intensive treatment. For those with a life expectancy of less than 1 year, the risk would be more likely to outweigh the benefit. The findings were based on analysis of six randomized trials reflecting the care of 27,414 patients 60 years and older who had hypertension. JUCM has addressed the dangers of dangerously high blood pressure in patients of diverse ages, and the best course of action in the urgent care center. You can read Managing Hypertensive Emergencies in the Urgent Care Setting in our archive now.