Management of elevated blood pressure and hypertension in hospitalized non-hypertensive patients : a systematic guideline review
Ojukwu, Gift Ezike, Adanna N Chukwu, Victor U Nnabude, Ogechukwu H Oghotuoma, Oghenemaro O
Ojukwu, Gift
Ezike, Adanna N
Chukwu, Victor U
Nnabude, Ogechukwu H
Oghotuoma, Oghenemaro O
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Affiliation
Leeds Teaching Hospitals NHS Trust; Forth Valley Royal Hospital; Abia State University; Windsor University School of Medicine; Walsall Healthcare NHS Trust
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Publication date
2025-06-13
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Abstract
The management practices of elevated blood pressure (BP)/hypertension (HTN) in patients hospitalized for non-hypertensive reasons vary, despite such patients recording BPs much higher compared to the levels proposed for outpatient contexts. Moreover, despite elevated BP being a widespread dilemma faced by most healthcare practitioners (HCPs), there are no universal guidelines to aid with the management of elevated BP in patients hospitalized for non-HTN reasons. Therefore, this systematic review seeks to identify and evaluate the most recent and contemporary guidelines on managing elevated BP and HTN in hospitalized patients for non-hypertensive reasons. To attain the stated objective, a robust method was employed to attain the study objective based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and Cochrane guidelines. Further, an exhaustive literature search was performed on online databases, including Medline, PubMed, Embase, Google Scholar, Web of Science, and Scopus. The study inclusion criteria stipulate that, to be included, the selected studies must have been published between 2015 and 2025, and in the English language. The selected studies were appraised using an appraisal tool for cross-sectional studies. Twelve studies satisfied the inclusion criteria and were reviewed. The study has demonstrated that the lack of universal guidelines for elevated BP management for patients hospitalized for non-HTN reasons poses a challenge to many HCPs, despite the existence of significant literature on elevated BP management. Available guidelines have continued to focus on the management of elevated BP and HTN in outpatient contexts. Consequently, HCPs increasingly rely on outpatient BP management guidelines in treating hospitalized patients for non-HTN reasons. Thus, regardless of the existing universal consensus on outpatient BP management, at present, there is no general guidance on inpatient management of elevated BP in non-HTN patients, and this has significantly contributed to the observed variations in practice patterns.
Citation
Ojukwu G, Ezike AN, Chukwu VU, Nnabude OH, Oghotuoma OO, Nwauwa O, Ehi Egege S, Okafor CN, Ihezie CO, Okobi OE, Mokwe C. Management of Elevated Blood Pressure and Hypertension in Hospitalized Non-hypertensive Patients: A Systematic Guideline Review. Cureus. 2025 Jun 13;17(6):e85904. doi: 10.7759/cureus.85904. PMID: 40656280; PMCID: PMC12255961.
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Article