The Management of Elevated Blood Pressure in the Acute Care Setting: A Scientific Statement From the American Heart...

Area of Science:

• Cardiology
• Nephrology
• Emergency Medicine

Background:

• Limited evidence exists for managing elevated blood pressure (BP) in acute care settings, unlike outpatient settings.
• This leads to significant practice variations in diagnosing and managing inpatient elevated BP.
• Elevated inpatient BP can be asymptomatic or indicate hypertensive emergency with target-organ damage.

Purpose of the Study:

• To synthesize available evidence on managing elevated inpatient BP.
• To provide best practice suggestions based on current evidence.
• To identify evidence gaps and areas for future research in acute care BP management.

Main Methods:

• Review of existing scientific literature and observational studies.
• Analysis of current practices in emergency departments and inpatient settings.
• Synthesis of evidence to address asymptomatic elevated BP and hypertensive emergencies.

Main Results:

• Hypertensive emergencies require prompt treatment with intravenous medications.
• The risk-benefit of treating asymptomatic elevated inpatient BP is unclear, yet often occurs.
• Observational studies suggest potential harm from treating asymptomatic elevated inpatient BP.

Conclusions:

• There is a critical need for evidence-based guidelines for acute care BP management.
• Current practices for asymptomatic elevated inpatient BP warrant re-evaluation.
• Further research is essential to optimize inpatient blood pressure management strategies.