Hypertension Registry at Wake Forest University
David Cline, M.D.
Project:
To establish nation’s first fully functional Emergency Department based Hypertension Registry that could serve as a prototype for expansion to the State of North Carolina and/or the United States.
To demonstrate that hypertensive patients identified in the emergency department can be successfully treated and referred with a measurable improvement in blood pressure control at follow-up.
Program:
The Hypertension Registry at Wake Forest University was funded by a grant from the Center for Disease Control and Prevention, through a cooperative agreement with the Association for Prevention Teaching and Research, September 30, 2002 through September 29 2006. The grant established the first Registry of Hypertensive patients based in the emergency department to assess a growing population of patients who preferentially utilize the Emergency Department for urgent care, or those who are unable to seek care elsewhere. David M. Cline, MD was the principal investigator on the grant. Carlos Ferrario, MD, and David C. Goff, Jr. MD, PhD were co-investigators.
Protocol:
All patients presenting to the emergency department age 18 years or older are screened for hypertension. The charts of all patients with blood pressure over 130/85 mm Hg or a history of hypertension (including medications) are reviewed in detail. At the completion of the project, over 22,000 patient visits were screened for elevated blood pressures. Forty percent of the patients seen in the emergency department have a blood pressure of 140/90 mm Hg or higher, and this compares to 30% of patients in emergency departments nationally, reflecting the increased prevalence of hypertension in the Southeast United States. We have found that minority patients are at increased risk for uncontrolled hypertension based on greater numbers of minority patient who lack health care insurance and a regular health care provider. In addition, the emergency department sees a large number of young hypertensive patients who have few other choices for health care. This Emergency Department based Hypertension Registry provides important information regarding patients at risk for complications of hypertension, particularly among the uninsured with no usual source of health care. The potential of this registry to prevent years of costly complications of hypertension through early identification and treatment of hypertensive patients is currently under investigation.
Although the project has been completed, those interested in the design and findings from the registry are welcome to contact the primary investigator, Dr. David Cline.
For further information:
David Cline, MD
Wake Forest University School of Medicine
Medical Center Boulevard
Winston-Salem, North Carolina, 27157-1089
Email: dcline@wfubmc.edu