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住院非高血压患者血压升高及高血压的管理:系统指南综述

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

作者信息

Ojukwu Gift, Ezike Adanna N, Chukwu Victor U, Nnabude Ogechukwu H, Oghotuoma Oghenemaro O, Nwauwa Obianuju, Ehi Egege Stella, Okafor Chidiogo N, Ihezie Cosmas O, Okobi Okelue E, Mokwe Chisom

机构信息

General Practice, Leeds Teaching Hospitals NHS Trust, Leeds, GBR.

Geriatrics, Forth Valley Royal Hospital, Larbert, GBR.

出版信息

Cureus. 2025 Jun 13;17(6):e85904. doi: 10.7759/cureus.85904. eCollection 2025 Jun.

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.

摘要

因非高血压原因住院患者的血压升高/高血压管理实践各不相同,尽管这些患者记录的血压水平比门诊情况下建议的水平高得多。此外,尽管血压升高是大多数医疗从业者(HCP)面临的普遍难题,但对于因非高血压原因住院患者的血压升高管理,却没有通用指南。因此,本系统评价旨在识别和评估关于因非高血压原因住院患者血压升高和高血压管理的最新和当代指南。为实现既定目标,采用了基于系统评价和Meta分析的首选报告项目(PRISMA)和Cochrane指南的稳健方法来实现研究目标。此外,还在包括Medline、PubMed、Embase、谷歌学术、科学网和Scopus在内的在线数据库上进行了详尽的文献检索。研究纳入标准规定,入选研究必须在2015年至2025年之间发表,且为英文。使用横断面研究评估工具对所选研究进行评估。十二项研究符合纳入标准并进行了综述。该研究表明,尽管存在大量关于血压升高管理的文献,但对于因非高血压原因住院患者的血压升高管理缺乏通用指南,这给许多HCP带来了挑战。现有指南继续侧重于门诊情况下血压升高和高血压的管理。因此,HCP在治疗因非高血压原因住院的患者时越来越依赖门诊血压管理指南。因此,尽管门诊血压管理存在普遍共识,但目前对于非高血压患者住院期间血压升高的管理没有一般指导,这在很大程度上导致了观察到的实践模式差异。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c7de/12255961/da87776dae64/cureus-0017-00000085904-i01.jpg

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