Initiation of oral antihypertensives in hospitalized patients with hypertensive urgency: A descriptive study.

This study investigates the impact of timing for initiating oral antihypertensive therapy on blood pressure (BP) reduction in hospitalized adult patients with hypertensive urgency, defined as systolic BP ≥180 mm Hg or diastolic BP ≥120 mm Hg without acute end-organ damage. Analyzing 220 patients stratified into quartiles based on time to first oral antihypertensive administration, the study found that earlier initiation—within approximately 5 hours of presentation—was associated with significantly greater and sustained reductions in systolic BP, diastolic BP, and mean arterial pressure over 48 hours, as well as faster achievement of target BP readings. The use of intravenous antihypertensives did not significantly alter these temporal trends, and length of hospital stay and continuation of home antihypertensives were similar across groups. These findings support guideline recommendations favoring early oral antihypertensive treatment in hypertensive urgency and suggest that intravenous agents may be unnecessary once hypertensive emergency is excluded.