Intravenous Antihypertensives Ordered for Patients With Asymptomatic Uncontrolled Blood Pressure

HealthDay News — Intravenous (IV) antihypertensives are often ordered and administered for patients with asymptomatic uncontrolled blood pressure (BP) levels that are not associated with immediate cardiovascular risk, according to a study published online November 12 in the Journal of Hospital Medicine.

Melissa Lipari, PharmD, from Wayne State University in Detroit, and colleagues examined the frequency of prescribing and administering episodic IV antihypertensives and outcome in non-critically ill, hospitalized patients. Data were included for 246 patients with an episodic IV antihypertensive order.

Of the patients with an episodic IV antihypertensive order, 172 received 458 doses, with 48% receiving a single dose. The researchers found that more than 98% and 84.5% of episodic IV antihypertensive doses were administrated for systolic blood pressure (SBP) of <200 mm Hg and <180 mm Hg, respectively. For patients receiving IV hydralazine and labetalol, there was a statistically significant decrease in average SBP and diastolic BP within 6 hours of administration. The oral inpatient medication regimen was adjusted in 52% of patients after administration of IV antihypertensives; compared to patients with no change to their oral regimens, these patients had a greater SBP reduction from admission to discharge.

“IV antihypertensive drugs are ordered and administered in patients with asymptomatic, uncontrolled BP for levels unassociated with substantive immediate cardiovascular risk, which may cause adverse effects,” the authors write.

Reference

Lipari M, Moser LR, Petrovitch EA, Farber M, Flack JM. As-needed intravenous antihypertensive therapy and blood pressure control. J Hosp Med. 2015; doi: 10.1002/jhm.2510.