Management of Asymptomatic Hypertension in the Inpatient Setting.

Hypertension is common in hospitalized patients and is most often asymptomatic. While there are no guidelines for managing such patients, aggressive blood pressure treatment, including using intravenous antihypertensives, is often undertaken. Although beneficial evidence is lacking, emerging data suggest that treating asymptomatic hypertension in the inpatient setting is associated with adverse outcomes, including acute kidney injury and ischemic stroke. In addition, intensifying a preexisting antihypertensive regimen at hospital discharge significantly increases the risk of readmission without significant improvement in outpatient hypertension control. Combining this common problem with the demonstrable benefit of a less aggressive approach offers considerable opportunity to improve patient care. This review will discuss the existing literature with a clinical scenario and make suggestions for practice improvement.