# Management of Elevated Blood Pressure and Hypertension in Hospitalized Non-hypertensive Patients: A Systematic Guideline Review

## TL;DR

This paper reviews guidelines for managing high blood pressure in hospitalized patients who aren't there for hypertension, finding a lack of universal inpatient guidelines.

## Contribution

The study identifies the absence of standardized guidelines for managing elevated blood pressure in non-hypertensive hospitalized patients.

## Key findings

- There are no universal guidelines for managing elevated BP in hospitalized non-HTN patients.
- Healthcare providers often use outpatient guidelines for inpatient BP management.
- Significant variations in practice exist due to the lack of inpatient-specific guidance.

## 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.