A new review released 1 December reveals that blood pressure medications may be unnecessarily overused in hospitals.
Published in Australian Prescriber, the review led by Flinders University pharmacologist Professor Arduino Mangoni highlights that while identifying and treating high blood pressure is important, elevated blood pressure when presenting to a hospital is relatively common and may not necessarily mean that a patient’s blood pressure has been an issue prior to admission.
Providing possible reasons for elevated blood pressure when presenting to a hospital, Professor Mangoni says this could be due to inaccurate measurements, and factors such as pain, anxiety, noise and interrupted sleep.
“The measurement of blood pressure in hospital patients significantly differs from the best practice recommended for primary care and outpatients,” says Professor Mangoni.
The review found recent studies suggest treating acute, asymptomatic, in-hospital elevations in blood pressure may have no benefit. Instead, they may increase the risk of in-hospital and post-discharge complications.
The authors say a significant problem in investigating in-hospital blood pressure elevations and their management is the lack of robust protocols.
“The industry needs to review the criteria used by hospital medical emergency teams in relation to blood pressure elevations,” says Professor Mangoni.
“Pending the development of robust measurement protocols in hospitalised patients, acute blood pressure elevations without additional symptoms or organ damage should not automatically equal treatment.
“Rather, such elevations should facilitate follow-up of blood pressure and other cardiovascular risk factors after discharge, including clear communication with GPs to appropriately plan investigations and management.”
