Key result
Aggressive treatment of asymptomatic inpatient hypertension is associated with adverse outcomes, including acute kidney injury and ischemic stroke, without improving outpatient control.
Why the study?
There are no guidelines for managing asymptomatic hypertension in hospitalized patients, and aggressive treatment lacks evidence of benefit while being associated with adverse outcomes.
Does aggressive treatment of asymptomatic hypertension in the inpatient setting improve clinical outcomes?
Does aggressive treatment of asymptomatic hypertension in the inpatient setting improve clinical outcomes?
Aggressive management of asymptomatic hypertension in hospitalized patients lacks evidence of benefit and is associated with increased risks of AKI, stroke, and readmission.
Should not yet change practice for asymptomatic inpatient hypertension; leaves open need for RCTs to confirm associations.
Hypertension is common in hospitalized patients and is most often asymptomatic. While there are no guidelines for management of such patients, aggressive blood pressure treatment, including the use of intravenous antihypertensives, is often undertaken. While evidence of benefit is lacking, emerging data suggest that treatment of asymptomatic hypertension in the inpatient setting is associated with adverse outcomes, including acute kidney injury and ischemic stroke. In addition, the intensification of a preexisting antihypertensive regimen at hospital discharge significantly increases the risk of readmission without significant improvement in outpatient hypertension control. Such a combination of a common problem with the demonstrable benefit of a less aggressive approach offers considerable opportunity to improve patient care. This review article will discuss the existent literature and a specific case and make suggestions for improvement of practice.
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Meadows et al. (2023) conducted a review in Asymptomatic hypertension. Aggressive blood pressure treatment vs. Less aggressive approach was evaluated. Aggressive treatment of asymptomatic inpatient hypertension is associated with adverse outcomes, including acute kidney injury and ischemic stroke, without improving outpatient control.
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