The purpose of this study is to study the impact of blood pressure on cognitive performance.

Four groups will be evaluated for possible impact of blood pressure on cognitive performance and retinal damage.

Inclusion Criteria:

1. Patients triaged to the Grady Memorial Hospital Emergency Department or Marcus Trauma Unit

2. Age >18 and <65

3. Documented history of hypertension plus one or more of the following:

   • current antihypertensive use with controlled blood pressure
   • elevated Emergency Department systolic blood pressure or diastolic blood pressure
   • OR -

4. Acutely elevated Emergency Department systolic blood pressure or diastolic blood pressure on 2 separate Emergency Department measurements in the absence of a history of hypertension

   • OR -

5. Normal systolic blood pressure or diastolic blood pressure in the absence of hypertension.

Exclusion Criteria:

1. Non-English speaking
2. Pre-visit cognitive impairment
3. Physical or psychological impairments that would prohibit comprehension and completion of DETECT testing
4. Inability to obtain adequate fundoscopic photos
5. Acute intoxication, altered mental status, or head injury within the last 6 months
6. Opiate or benzodiazepine administration by treating providers
7. Clinical condition not allowing testing.

Emergency department patients that meet the inclusion/exclusion criteria.