Evaluating Whether Treating Elevated Blood Pressure in the Inpatient Setting Impacts Patient Outcomes
Trial Parameters
Brief Summary
The vast majority of the 36.2 million individuals admitted to U.S. hospitals are diagnosed with hypertension and experience an elevated blood pressure (BP) reading during hospitalization. There are no guidelines for managing asymptomatically elevated BPs in the inpatient setting, and growing observational evidence suggests that antihypertensive medication intensification increases harm. The proposed study tests whether a unit-based intervention (ACT-BP) can reduce antihypertensive medication intensification and provides information that is scientifically necessary for designing a cluster-randomized clinical trial that identifies the impact of intensification after experiencing an asymptomatically elevated BP on patient outcomes.
Eligibility Criteria
Inclusion Criteria: * At the unit level: Medical units that do not typically care for patients requiring step-down care. Exclusion Criteria: 1. Patients less than 18 2. Patients experiencing hypertensive emergencies or cardiac symptoms 3. Patients with active cardiovascular events, such as * Stroke * Non-ST-elevation * Myocardial infarction * End-stage renal disease * Patients on dialysis * Those with acute decompensated heart failure 3\. Patients on the unit for more than 10 days 4\. Patients transferred in after being in the intensive care unit (ICU) 5\. Pregnant and post-partum women 6\. Patients discharged within 24 hours of admission 7\. Patients whose systolic BP remains below 160 mmHg during hospitalization.