Background: People experiencing homelessness (PEH) face barriers to accessing regular ambulatory care, which increases their risk of having poorly controlled chronic medical conditions and contributes to high acute care utilization. The role of field-based homeless healthcare teams in improving hypertension and diabetes control and reducing acute care utilization (e.g., emergency department [ED] visits, inpatient hospitalizations) [...]

Case Presentation: Patient is a 45-year-old female with a history of esophageal reflux and dysmotility, asthma, depression/anxiety, and recent SARS-2-CoV infection (COVID-19) who presented to our hospital 9 months after initial and 3 months after recurrent COVID-19 with headache, dyspnea, and home blood pressures (BP) > 180/100. Patient reported intermittent symptoms for the last 3 [...]

Case Presentation: A previously healthy 4-year-old female born in Mexico was sent to the emergency department for elevated blood pressures noted at her routine outpatient clinic visit. On arrival, her blood pressure was 161/126. The patient reported polydipsia, polyuria, and weight loss. Her initial physical exam was unremarkable and her vitals were otherwise within normal [...]

Background: Results from the recent SPRINT trial demonstrate lower rates of fatal and non-fatal major cardiovascular events and all-cause mortality in non-diabetics at high cardiovascular risk with intensive versus standard treatment, i.e., less than 120 versus less than 140 mmHg systolic, respectively. However, the long-term outcomes remain unknown.Methods: A validated state-transition model with multivariate risk [...]

Background: There is evidence that significantly disruptive health events, such as hospitalizations, may increase patients’ receptiveness to interventions that lead to healthier lifestyle choices and medication adherence. For example, research has shown that hospitalizations are particularly effective settings for delivering some interventions aimed at preventing chronic disease morbidity, such as intervening on tobacco use. Additional [...]

Background: Transient elevations of blood pressure are common in hospitalized older adults and may lead inpatient clinicians to intensify inpatient antihypertensive therapy and discharge patients on these intensified regimens. Intensification of outpatient regimens during hospitalization can easily become over-treatment once patients return home, increasing patients’ risk of adverse drug events including syncope and falls. Thus, [...]

Background: Approximately 10% adults with Sickle Cell disease (SCD) has Pulmonary hypertension (PHTN). There are several etiologies like hypoxia driven and microvascular obstruction contributing to PHTN. However, the in-hospital outcomes of PHTN on SCD has not been well studied. Methods: We queried 2018 National Inpatient Sample (NIS) database to identify SCD and different types of [...]

Background: There is no consensus on the management of asymptomatic inpatient hypertension. This is alarming as the prevalence of inpatient hypertension may be as high as 72%. Hypertension treatment guidelines focus on chronic hypertension in the outpatient setting and evidence for inpatient management is lacking. Aggressive treatment of asymptomatic inpatient hypertension with intravenous antihypertensives is [...]

Background: Though the advent of highly active anti-retroviral medications has improved survival in HIV infection, mortality from non-infectious complications such as pulmonary arterial hypertension (PAH) has increased. Also, studies have shown that PAH is the leading cause of hospitalization and death in patients with HIV associated PAH (HIV-PAH). However, not much is known about the [...]

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 [...]