Elevated Diastolic, But Not Systolic, Blood Pressure Measured in the Emergency Department Predicts Future Development of Hypertension in Normotensive Individuals

Elevated blood pressure ( BP ) is reported in many individuals without hypertension presenting to the emergency department ( ED ). Whether this condition represents a transient state or is predictive for the development of future hypertension is unknown. This observational prospective study investigated patients admitted to an ED without a diagnosis of hypertension in whom BP values were ≥140/90 mm Hg. The primary outcome was development of hypertension during follow‐up. Overall, 195 patients were recruited and at the end of follow‐up (average 30.14±15.96 months), 142 patients were diagnosed with hypertension (73%). The mean age (50±12.25 vs 48.31±13.9, P =.419) and sex distribution (78 men/64 women vs 24 men/20 women, respectively; P =.148) were similar in both groups. There were significant differences in systolic and diastolic BP between those who developed hypertension on follow‐up and those who did not (177.6 mm Hg±22.6/106.1 mm Hg±16.9 vs 168.6 mm Hg±18/95.2 mm Hg±12.2; P =.011 for systolic BP , P <.001 for diastolic BP ). In multivariate analysis the only significant predictive factor for the development of hypertension was diastolic hypertension recorded in the ED ( P =.03). Elevated diastolic, but not systolic, BP among patients presenting to the ED is associated with future development of hypertension in previously normotensive individuals.