There is a growing number of patients who present to A&E with hypertension, either recorded by themselves at home, in a pharmacy, or by their GP. Other patients may have high blood pressure as an incidental finding when they present with another complaint. There is a temptation to treat these numbers, either with nifedipine (peak plasma concentration 2-3hr) or – even worse - amlodipine (peak plasma concentration 6-8hr). This prolongs ED stay and may be unsafe (who is monitoring their BP if they go home before the drug has reached peak levels?)

 

Retrospective observational study: Annals of Emergency Medicine, November 2018.

Clinical review and expert opinion article: JAMA Internal Medicine, May 2018