Intensive blood pressure treatment may cause heart and kidney injury

Credit: Unsplash+

A study led by physician-researchers at Beth Israel Deaconess Medical Center (BIDMC) indicates that intensive high blood pressure treatment for hospitalized older adults may lead to a higher risk of adverse events.

This suggests that treating transiently elevated blood pressure, or asymptomatic hypertension, may not be beneficial.

The findings, published in JAMA Internal Medicine, emphasize the need for further research to develop best practices for managing inpatient blood pressure.

Methodology

Researchers examined the treatment of elevated blood pressure in more than 66,000 older adults who were hospitalized for non-cardiac conditions.

Using clinical and pharmacy data from the national Veterans Health Administration (VHA), they compared outcomes for patients who received intensive blood pressure treatment in the first 48 hours after admission to those who did not.

Key Findings

The study found that one in five patients received intensive treatment for blood pressure, defined as additional antihypertensive medications the patient had not been taking at home prior to hospitalization.

Of these, 18 percent received the medication intravenously.

Compared to patients with elevated blood pressure who did not receive intensive treatment within the first 48 hours of hospitalization, those who did were at a greater risk for adverse clinical outcomes, including cardiac injury, acute kidney injury, and ICU transfer.

Receiving antihypertensives intravenously further heightened the risk.

Comments from the Researchers

Corresponding author Timothy S. Anderson, MD, MAS, a clinical investigator in the Division of General Medicine at BIDMC, explained that “in the hospital, blood pressure is often elevated due to pain, fever, anxiety, new medication, and other hospital factors.

It is not clear that treating transient elevations with blood pressure medications is helpful, it may instead result in overtreatment.”

He suggested that “the common practice of acutely treating asymptomatic inpatient blood pressure could be harmful and the use of intravenous antihypertensives, in particular, should be discouraged.

Until we have more definitive randomized clinical trial data, our findings suggest that the safest path forward is likely to rethink the underlying reason for inpatient blood pressure measurement and reorient clinical practice.”

Significance

Severely high blood pressure can lead to a heart attack, stroke, or damage to blood vessels and organs, so it is closely monitored in hospitalized patients.

However, this study suggests that treating asymptomatic hypertension in these patients may lead to adverse outcomes, highlighting the need for improved inpatient blood pressure management guidelines.

If you care about blood pressure, please read studies about unhealthy habits that could increase high blood pressure risk, and this vitamin could help reduce tough high blood pressure.

For more information about blood pressure, please see recent studies that early time-restricted eating could help improve blood pressure, and results showing new cause of high blood pressure and heart disease.

The study was published in JAMA Internal Medicine.

Copyright © 2023 Knowridge Science Report. All rights reserved.