Most IV Hypertension Drugs Ordered for Patients without Immediate CV Risk

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Many IV antihypertensives are often administered to patients with blood pressure levels not linked to immediate CV risk.
Many IV antihypertensives are often administered to patients with blood pressure levels not linked to immediate CV risk.

(HealthDay News) — Intravenous (IV) antihypertensives are often ordered and administered for patients with asymptomatic uncontrolled blood pressure levels that are not associated with immediate cardiovascular risk, according to a study published 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 of <200 mm Hg and <180 mm Hg, respectively. 

For patients receiving IV hydralazine and labetalol, there was a statistically significant decrease in average systolic blood pressure and diastolic blood pressure within 6 hours of administration. The oral inpatient medication regimen was adjusted in 52% of patients after administration of IV antihypertensives. Compared with patients with no change to their oral regimens, these patients had a greater systolic blood pressure reduction from admission to discharge.

"IV antihypertensive drugs are ordered and administered in patients with asymptomatic, uncontrolled [blood pressure] for levels unassociated with substantive immediate cardiovascular risk, which may cause adverse effects," the researchers wrote.

Reference

  1. 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.
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