Things We Do for No Reason™: Intensifying antihypertensive medications for hospitalized patients at the time of discharge

Abstract

A 63-year-old male with essential hypertension, chronic obstructive lung disease (COPD), diabetes, and hyperlipidemia presented to the emergency department (ED) with 2 days of shortness of breath. The ED clinician diagnosed him with a COPD exacerbation and admitted him to the hospital. He has taken hydrochlorothiazide 25 mg daily and lisinopril 20 mg daily for the past 3 years. In his primary care clinic, his blood pressure (BP) typically measures between 125/70 and 140/ 80 mmHg. Throughout his hospital stay, his BP ranged from 148/79 to 175/102 mmHg. By hospital Day 4, his dyspnea has resolved, and he feels well, but his BP remains 156/91 mmHg. The hospitalist team considers increasing his antihypertensives before discharge.