An Evidence-Based Review of Elevated Blood Pressure for the Inpatient

Am J Med. 2020 Feb;133(2):165-169. doi: 10.1016/j.amjmed.2019.10.004. Epub 2019 Nov 6.


Elevated blood pressure is common in patients who are hospitalized. There are no guidelines and few recommendations to help inpatient providers manage patients with elevated blood pressure. There are no normal reported values for blood pressure in the inpatient and recording circumstances often widely vary. Many factors may influence blood pressure such as pain, anxiety, malaise, nicotine withdrawal, or withholding home medications. This review of available literature suggests potential harm and little to no potential benefit in treating asymptomatic patients with elevated blood pressure. This review also found no evidence that asymptomatic elevated blood pressure progresses to lead to end-organ damage. However, there are clear instances of hypertensive emergency where treatment is indicated. Conscientious adjustment of an anti-hypertensive regimen should be undertaken during episode of elevated blood pressure associated with end-organ damage.

Keywords: Acute severe hypertension; Antihypertensive; Asymptomatic; Hospitalized patient; Hypertension; Hypertensive emergency; Hypertensive urgency.

Publication types

  • Review

MeSH terms

  • Antihypertensive Agents / therapeutic use
  • Blood Pressure*
  • Humans
  • Hypertension / diagnosis*
  • Hypertension / drug therapy
  • Hypertension / etiology*
  • Inpatients*


  • Antihypertensive Agents