Overtreatment of Blood Pressure in Hospitalized Patients

Although evidence-based recommendations exist for outpatient management of hypertension, guidelines for treating inpatients with elevated blood pressure (BP) are lacking. Recent data suggest that a less-intensive approach is best.

In two studies, researchers aimed at lower use of intravenous (IV) hydralazine or labetalol in asymptomatic inpatients with elevated BP. In a study of 2000 hospitalized adults, an educational campaign and electronic medical record intervention (changing BP notification parameters from >160/90 mm Hg to >180/90 mm Hg) reduced use of antihypertensive medications (from 11% of patients to 7%), without a change in patient-centered outcomes (NEJM JW Gen Med Jun 1 2019 and J Hosp Med 2019; 14:144). In another study, nurses…