You are in the hospital with an acute illness. Maybe your gallbladder is working, doubling you with abdominal pain. While taking care of you and your gallbladder, the doctors noticed that your blood pressure was high. So they adjust your blood pressure medication to get it back to normal. Everything seems hunky-dory.
But if you don’t get careful and careful monitoring, these blood pressure pills could do more harm than good.
In a recent article, I showed how common it is for patients to be given antibiotics in hospital even when the drugs do more harm than good. Well, here’s another harmful practice: adding new blood pressure medications to patients whose blood pressure rises during hospital stays. Sometimes it is important to prescribe such drugs. But other times, patients have good blood pressure control at home, and their blood pressure rises in the hospital simply as an artifact of their acute condition. For example, a sharp pain speeds up your sympathetic nervous system, causing your blood pressure to rise. In such a situation, being given a new blood pressure medication increases the risk that a patient will need to be readmitted to the hospital within 30 days of discharge, possibly because their blood pressure drops when they return home. Here’s an image, taken from a UCSF study showing increased readmission rates for people given these unnecessary drugs for hypertension:
Doctors need to be more careful when adding new blood pressure medications to treat high blood pressure in hospital patients. The increase in blood pressure under such circumstances could simply be an artefact of acute illness.
And anyone with high blood pressure should also be careful. If you receive a new medicine for high blood pressure while you are in the hospital, or if you take more medicine than you are already taking, ask your doctor if you should continue to take the new medicines after you come home. Also, be sure to have your blood pressure checked regularly after you are discharged from the hospital, to see if it starts to drop too much. If you start to feel dizzy, call your primary care doctor for advice.
Medicines for high blood pressure are drugs that save lives because they prevent heart attacks, strokes, kidney disease, and a host of other problems. Just be careful to make sure, when you leave the hospital, that you don’t get too many good things.