Background: Elevated blood pressure (BP) is common among hospitalized patients, with prevalence estimates between 50-70%. Many factors may contribute to this, such as pain, nausea, anxiety, or volume overload. However, true hypertensive emergency requiring rapid reduction in BP is relatively rare. The easy availability of intravenous (IV) antihypertensives may lead to unnecessary treatment of asymptomatic [...]

Background: Intravenous (IV) anti-hypertensive medications such as labetalol and hydralazine are commonly administered as needed or “prn” to asymptomatic patients in the hospital with elevated blood pressure. This practice may lead to patient harm (such as hypotension or stroke) and increased costs without any known benefit. Much attention has been focused on this issue in [...]

Background: Hypertension occurs in up to 75% of hospitalized patients. However, less than 1% have “hypertensive emergency,” defined as severely elevated blood pressure (BP) with end-organ injury. Current guidelines support emergent treatment of hypertensive emergency but recommend against immediate reduction of severely elevated BP in patients without end-organ injury (i.e., asymptomatic hypertension). Recent literature suggests [...]