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Treating Numbers or Patients? Rethinking Supine Hypertension in Hospitalized Adults

Abstract

In-hospital blood pressure (BP) monitoring often leads to the detection of isolated elevated readings, particularly in the supine position during nighttime checks. However, growing evidence suggests that these transient hypertensive values – frequently labeled as “supine hypertension” – may not warrant pharmacologic intervention in the absence of acute end-organ damage. This opinion piece argues against the reflexive treatment of supine hypertension in hospitalized patients and highlights the risks associated with aggressive management. Excessive monitoring and the lack of contextual interpretation of BP fluctuations may expose patients to unnecessary harm.

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ABC

Editorial

A New Era of Hypertension Assessment: Non-Invasive Central and Intracranial Waveform Analysis

Juan Carlos Yugar-Toledo et al. Heitor Moreno

The relationship between arterial hypertension and cerebral blood flow (CBF) has been extensively studied due to the role that blood pressure plays in maintaining adequate cerebral perfusion. Cerebral autoregulation is the mechanism by which cerebral blood flow remains relatively constant despite variations in perfusion pressure. In normotensive individuals, the autoregulation range is approximately between mean arterial pressures of 60 to 150 mmHg.^,

In hypertensive patients, there is evidence that this curve shifts to higher values, causing: a) The hypertensive brain to tolerate higher blood pressures before vasodilation or vasoconstriction occurs; b) On the other hand, abrupt drops in blood pressure can result in cerebral hypoperfusion, since the lower threshold for autoregulation may be higher.

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Treating Numbers or Patients? Rethinking Supine Hypertension in Hospitalized Adults

Abstract

A New Era of Hypertension Assessment: Non-Invasive Central and Intracranial Waveform Analysis

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Electronic Document Format (Vancouver)

Electronic Document Format (ABNT)

Electronic Document Format (APA)

Electronic Document Format (ISO)