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Evidence suggests that hospitalized patients who develop elevated blood pressure (BP) in the absence of acute target organ effects should not be treated with intravenous (IV) antihypertensive drugs (NEJM JW Gen Med Jun 1 2019 and J Hosp Med 2019; 14:144; NEJM JW Gen Med Feb 15 2021 and JAMA Intern Med 2021; 181:345). But does this restriction apply to patients with severely elevated BP? Researchers performed a retrospective cohort study in 200,000 non–critically ill adult inpatients (with diagnoses other than hypertensive emergency) who were admitted to a Connecticut hospital network. Approximately 20,000 patients (9%) met criteria for severe hypertension (defined as systolic BP >180 mm Hg or diastolic BP >110 mm Hg), of which ≈1000 receive…