Fleming et al,¹ in this issue of the EMJ, present further evidence that hypertension identified in the emergency department (ED) should not simply be dismissed as secondary to pain, anxiety or “white coat” effect. Their finding that 28% of patients with “minor injuries” were hypertensive should not surprise, as the British Society for Hypertension reports that 42% of 35-64 year olds in the UK have hypertension.² Clearly, we can screen for hypertension in the ED but should we do so?

Few would disagree that tight control of blood pressure across the UK population would prevent a significant number of deaths from myocardial infarction …