{"id":"45960","type":"article","url":"https://hartvaat.nl/2026/05/26/acute-bloeddrukverhoging-tijdens-ziekenhuisopname-hoe-te-handelen-bij-asymptomat/","title":"Acute bloeddrukverhoging tijdens ziekenhuisopname: hoe te handelen bij asymptomatische 'hypertensieve urgentie'?","title_en":"","category":"algemeen","category_label":"Algemeen","professions":["cardioloog","huisarts","internist"],"tags":[],"journal":"Heart","doi":"http://heart.bmj.com/cgi/content/short/112/12/658?rss=1","source_url":"https://doi.org/http://heart.bmj.com/cgi/content/short/112/12/658?rss=1","authors":["Etemadi","A.","Kumar","P.","Anderson","T. S.","Chang","T. I."],"significance":6,"published":"2026-07-04","source_date":"2026-05-26","image":"","kennis":["https://hartvaat.nl/kennis/antistolling/doacs-overzicht/","https://hartvaat.nl/kennis/coronairlijden/secundaire-preventie-na-acs/"],"congress":"","summary_en":"Heart BMJ review of pragmatic management of acute blood pressure elevations during hospitalisation. True hypertensive emergencies (with end-organ damage) are relatively rare and have clear guidelines; asymptomatic acute BP elevations are far more frequent and lack consensus on appropriate management. Contributing factors: fear of missing true emergencies, limitations in inpatient BP measurement accuracy, and inconsistent data on short- and long-term effects of inpatient BP elevations. Practice varies widely — even within a single hospital — between observation, intravenous or oral antihypertensives, and adjustment of home medication. Some clinicians discharge patients on intensified therapy based on inpatient values. The review synthesises the available evidence and provides a practical, holistic framework for evaluation and treatment.","created":"2026-07-03T20:26:58Z","updated":"2026-07-03T20:26:58Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Overzichtsartikel in Heart BMJ over het pragmatische beleid bij acute bloeddrukverhoging tijdens ziekenhuisopname. Echte hypertensieve emergencies (met eindorgaanschade) zijn relatief zeldzaam en hebben duidelijke richtlijnen; asymptomatische acute BD-verhogingen zijn echter veel frequenter zonder consensus over de juiste aanpak. Bijdragende factoren: angst om echte emergencies te missen, beperkingen in nauwkeurigheid van klinische BD-meting in het ziekenhuis, en weinig consistente data over korte- en langetermijneffecten van inpatient BD-verhogingen. De praktijk varieert sterk — zelfs binnen één ziekenhuis — tussen observatie, intraveneuze of orale antihypertensiva en aanpassingen aan thuismedicatie. Sommige clinici ontslaan patiënten met geïntensiveerde therapie op basis van ziekenhuiswaarden. De review synthetiseert het beschikbare bewijs en biedt een praktisch holistisch raamwerk voor evaluatie en behandeling.","abstract_original":"<p>Elevated blood pressure (BP) in the inpatient setting is frequently encountered by most healthcare providers. While there is general consensus on the management of acute BP elevations when associated with end-organ damage, these cases of true hypertensive emergency are relatively infrequent. In contrast, asymptomatic acute BP elevations are considerably more frequent, yet there is little consensus on their appropriate management. Contributing factors include concerns about missing true emergencies, the barriers affecting the accuracy of inpatient BP measurements and a lack of consistent data on the short- and long-term impact of inpatient BP elevations. Practice varies widely, even between departments within the same hospital, and includes observation, intravenous antihypertensives, oral agents and adjustments to existing regimens. Some clinicians also choose to discharge patients on intensified therapy based on inpatient BP values. However, despite the high prevalence of elevated BP in the inpatient setting, evidence remains heterogeneous and fragmented. This review aims to synthesise current knowledge and provide a practical, holistic framework for evaluating and managing elevated BP in the inpatient setting.</p>"}