title: An Update on Inpatient Hypertension Management.
abstract: Hypertension is highly prevalent affecting nearly one third of the US adult population. Though generally approached as an outpatient disorder, elevated blood pressure is observed in a majority of hospitalized patients. The spectrum of hypertensive disease ranges from patients with hypertensive emergency including markedly elevated blood pressure and associated end-organ damage to asymptomatic patients with minimally elevated pressures of unclear significance. It is important to note that current evidence-based hypertension guidelines do not specifically address inpatient hypertension. This narrative review focuses primarily on best practices for diagnosing and managing nonemergent hypertension in the inpatient setting. We describe examples of common hypertensive syndromes, provide suggestions for optimal post-acute management, and point to evidence-based or consensus guidelines where available. In addition, we describe a practical approach to managing asymptomatic elevated blood pressure observed in the inpatient setting. Finally, arranging effective care transitions to ensure optimal ongoing hypertension management is appropriate in all cases.
authors.affiliation: Division of General Internal Medicine and Geriatrics, Department of Medicine, The Medical University of South Carolina, Ralph H. Johnson VAMC, 109 Bee Street, MSC 111, Charleston, SC, 29401, USA. axon@musc.edu.|Ralph H. Johnson Veterans Affairs Medical Center, Ralph H. Johnson VAMC, 109 Bee Street, MSC 111, Charleston, SC, 29401, USA. axon@musc.edu.
authors.forename: R Neal
authors.initials: RN
authors.lastname: Axon
authors.affiliation: The Medical University of South Carolina College of Medicine, Ralph H. Johnson VAMC, 109 Bee Street, MSC 111, Charleston, SC, 29401, USA. turnerm@musc.edu.
authors.forename: Mason
authors.initials: M
authors.lastname: Turner
authors.affiliation: Ralph H. Johnson Veterans Affairs Medical Center, Ralph H. Johnson VAMC, 109 Bee Street, MSC 111, Charleston, SC, 29401, USA. buckleyr@musc.edu.
authors.forename: Ryan
authors.initials: R
authors.lastname: Buckley
mesh_terms: D000959:Antihypertensive Agents / Q000627:therapeutic use*; D019468:Disease Management; D019317:Evidence-Based Medicine; D006333:Heart Failure / Q000150:complications; D006760:Hospitalization; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000209:etiology; D006977:Hypertension, Renal / Q000188:drug therapy; D017202:Myocardial Ischemia / Q000150:complications
chemical_list: D000959:Antihypertensive Agents
keywords: Cardiovascular disease; Hospitalization; Hypertension; Hypertensive emergency