The Curbsiders Internal Medicine Podcast

#310 No Tension About Inpatient Hypertension

Dec 13, 2021
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INSIGHT

Hospital Readings Don't Equal Hypertension

  • Inpatients with elevated BP usually should be labeled as "elevated blood pressure," not new chronic hypertension.
  • Hospital readings alone rarely meet outpatient diagnostic standards for hypertension.
ADVICE

Investigate Reversible Causes First

  • Ask why BP is high: missed home meds, pain, anxiety, withdrawal, urinary retention, dialysis timing, or sympathetic surge.
  • Treat reversible causes before escalating antihypertensives in-hospital.
INSIGHT

Hospital Impact On Long-Term BP Is Limited

  • Most inpatient BP interventions aim for long-term benefits but produce short-term risk without long-term gain.
  • Often the correct inpatient action is reflection and arranging follow-up, not immediate escalation.
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