The Curbsiders Internal Medicine Podcast #144 NephMadness: Inpatient Hypertension
Mar 18, 2019
Three nephrology experts discuss inpatient hypertension, including how to respond to overnight nursing calls for elevated blood pressures and the role of treating hypertensive urgency in the hospital. They also explore the question of whether ACE-inhibitors are dangerous to give or hold during an operation. This episode provides insights into the role of anti-hypertensives in the inpatient setting.
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Distinguishing Hypertensive Emergency
- Hypertensive emergency involves high blood pressure with end organ damage, unlike hypertensive urgency.
- End organ damage signs include mental status changes, chest pain, or kidney issues.
Skepticism About Hypertensive Urgency
- The concept of hypertensive urgency may be artificial and potentially harmful.
- Labeling it can lead patients to anxiety and unnecessary hospital admissions.
Outpatient Management of Hypertensive Urgency
- Avoid admitting patients with hypertensive urgency; manage them outpatient.
- Do not give IV meds for hypertensive urgency; treat underlying causes instead.