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.
When managing hypertensive urgency, it is important to stop giving IV medications and assess the patient's blood pressure regimen.
There is no consensus on whether to continue or stop ACE inhibitors and ARBs before surgery, with conflicting advice from different guidelines.
Deep dives
Management of Hypertensive Urgency
When managing hypertensive urgency, it is important to stop giving IV medications and assess the patient's blood pressure regimen.
Perioperative Use of ACE Inhibitors and ARBs
There is no consensus on whether to continue or stop ACE inhibitors and ARBs before surgery. The limited existing data is observational and retrospective, and different guidelines offer conflicting advice.
Considerations for IV Hydralazine
IV hydralazine should not be given as a PRN medication for blood pressure management, as there is no evidence to support its use. Intraoperative hypotension may occur, and there are potential adverse effects.
The Chase for the Neff Madness Crown
The Neff Madness competition offers a chance to showcase expertise in nephrology and compete for bragging rights and prizes. Participants can fill out brackets and join in the fun of a nephrology-themed party.
Inpatient hypertension is tricky. What’s the best way to answer those overnight nursing phone calls for elevated blood pressures? What’s the role of treating hypertensive urgency in the hospital? Plus, Our nephrology experts put a new issue on the generalist’s radar: are ACE-inhibitors dangerous to give (or hold) during an operation? This NephMadness 2019 episode, features special guests Dr. Pascale Khairallah (@Khairallah_P), Dr. Charlie Wray (@WrayCharles) and Dr. Joel Topf (@kidneyboy) to better understand the role of anti-hypertensives in the inpatient setting and keep your blood pressure down on those overnight calls.
Full show notes available at https://thecurbsiders.com/episode-list. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.
Credits
Written and produced by: Justin Berk MD, MPH, MBA; Pascale Khairallah MD
Hosts: Matthew Watto MD, Paul Williams MD, Stuart Brigham MD
Edited by: Matthew Watto, MD
Guest: Pascale Khairallah MD, Charlie Wray DO, Joel Topf MD