Review reveals overuse of in-hospital blood pressure medications

A new review has found that blood pressure medications may be unnecessary received by patients with non-heart related conditions.

Patients in hospital for non-heart related conditions may be unnecessarily receiving blood pressure medications that has no benefit and could instead be harmful in the short term, a new review released has found.

Led by Flinders University pharmacologist Professor Arduino Mangoni, the article published in Australian Prescriber highlights that while identifying and treating high blood pressure in the community is of vital importance, it’s likely that in-hospital elevations in blood pressure are relatively common and might not reflect poorly controlled blood pressure before admission.

“The measurement of blood pressure in hospital patients significantly differs from the best practice recommended for primary care and outpatients,”  Professor Mangoni said, a Strategic Professor of Clinical Pharmacology at Flinders’ College of Medicine and Public Health.

“Measurements may be taken inaccurately, and in many cases factors such as pain, anxiety, noise and interrupted sleep patterns may be contributing to abnormal readings that do not need to be medically treated.”

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,” Professor Mangoni said.

“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.”

The paper – ‘Blood pressure elevations in hospital’ by Arduino A Mangoni, Elzbieta A Jarmuzewska, Genevieve M Gabb and Patrick Russell – is published in the journal Australian Prescriber.

News release from Flinders University. Note: Content has been edited for style and length.

Ritchelle Drilon

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Ritchelle is a Content Producer for Healthcare Channel, Australia’s premier resource of information for healthcare.

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