As an example, older adult patients may be at particularly high risk for cerebral or myocardial ischemia if the blood pressure is lowered excessively and/or too rapidly. In such patients, who often will have a high pulse pressure (eg, diastolic blood pressure <90 mmHg with systolic blood pressure ≥180 mmHg), the initial goal blood pressure may need to be achieved even more slowly (eg, over a week or more).
Management of severe asymptomatic hypertension (hypertensive urgencies) in adults – UpToDate
- The use of as needed antihypertensive medication is associated with an abrupt drop in blood pressures, increased risk of ischemic events, in-hospital mortality, and longer length of stay. We suggest that the routine use of as needed antihypertensive medication should be discouraged.
More About Treating Inpatient Hypertension with IV Antihypertensives (jwatch.org)
- Conclusions and Relevance In this cohort study, hypertension was common among medical inpatients, but antihypertensive treatment intensification was not. Intensification of therapy without signs of end-organ damage was associated with worse outcomes.Conclusions and Relevance In this cohort study, hypertension was common among medical inpatients, but antihypertensive treatment intensification was not. Intensification of therapy without signs of end-organ damage was associated with worse outcomes.