title: Treatment of hypertension in the inpatient setting: use of intravenous labetalol and hydralazine.
abstract: Acute blood pressure elevations are commonly treated in hospitalized patients. There are no guidelines for appropriate practice and no evidence that such treatment is useful. The authors performed a retrospective review of medical and pharmacy records to determine how often intravenous hydralazine and labetalol are ordered and administered. During a 1-year study period, a total of 29,545 hospitalizations were recorded. The authors identified 2189 patients (7.4% of all patients) for whom 7242 orders were written for hydralazine as needed (10-20 mg per dose) and 5915 for labetalol (10-20 mg per dose). Ordered drugs were administered in 60.3% of patients, and the average number of doses administered was 5.3+/-8.2 (mean +/- SD) for hydralazine and 5.6+/-7.7 for labetalol. Hospital length of stay (LOS) for patients for whom hydralazine was ordered was 12.0+/-15.9 days for those who received at least 1 dose and 7.1+/-9.0 days for those who did not receive a dose (P<.001). For patients for whom labetalol was ordered, patients receiving at least 1 dose had an LOS of 11.8+/-16.1 days vs 7.9+/-10.4 days for those who did not receive a dose (P<.001). Treatment of elevated blood pressure in in-patients is a common practice. The authors suggest that evidence is needed to determine whether the practice is of benefit.
authors.affiliation: Department of Internal Medicine, University of Michigan, Ann Arbor, MI 48106, USA. aweder@umich.edu
authors.forename: Alan B
authors.initials: AB
authors.lastname: Weder
authors.forename: Steven
authors.initials: S
authors.lastname: Erickson
mesh_terms: D000328:Adult; D000368:Aged; D000959:Antihypertensive Agents / Q000008:administration & dosage*; D005260:Female; D006760:Hospitalization; D006801:Humans; D006830:Hydralazine / Q000008:administration & dosage*; D006973:Hypertension / Q000188:drug therapy*; D007262:Infusions, Intravenous; D007741:Labetalol / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D000959:Antihypertensive Agents; D006830:Hydralazine; D007741:Labetalol