Persistent Hypertension After Asymptomatic Elevated In-Hospital Blood Pressure: The INDEBP Study
- 1University Hospital Basel and University of Basel
Abstract
BackgroundElevated blood pressure (BP) is common during hospitalization. Despite recommendations to avoid routine changes in antihypertensive therapy, clinical practice remains variable. Prospective data on whether elevated in-hospital BP identifies patients with hypertension after discharge are limited.
MethodsAdults hospitalized for non-cardiac conditions with asymptomatic routine in-hospital BP [≥]140 and/or [≥]90 mmHg on at least two occasions separated by [≥]24 hours were prospectively enrolled. Antihypertensive therapy was managed at the discretion of treating physicians. Routine in-hospital BP, standardized research BP, and changes in antihypertensive therapy were recorded. Four weeks after discharge, participants underwent 24-hour ambulatory BP monitoring (ABPM).
ResultsAmong 50 participants, 42 (84%; 95% CI, 70.9 - 92.8) had hypertension on follow-up ABPM. Among 21 participants without known hypertension, 18 (86%) had previously unrecognized hypertension on follow-up ABPM; among 29 participants with known hypertension, 24 (83%) had uncontrolled hypertension. Antihypertensive therapy was changed during hospitalization in 26 participants (52%), with de-escalation more frequent than intensification. Hypertension on follow-up ABPM was present in 88.5% of participants with and 79.2% without in-hospital therapy changes. Standardized research BP, but not routine in-hospital BP, correlated with follow-up ABPM.
ConclusionAsymptomatic elevated routine in-hospital BP identified a population with a high prevalence of hypertension four weeks after discharge, including patients with and without previously diagnosed hypertension. These findings support structured post-discharge BP reassessment rather than assuming that elevated in-hospital BP is transient.
URL: www.ClinicalTrials.gov; Unique identifier: NCT06132451
O_FIG O_LINKSMALLFIG WIDTH=200 HEIGHT=199 SRC="FIGDIR/small/26365097v1_ufig1.gif" ALT="Figure 1"> View larger version (76K): [email protected]@151c2b4org.highwire.dtl.DTLVardef@c5b819org.highwire.dtl.DTLVardef@b98117_HPS_FORMAT_FIGEXP M_FIG C_FIG
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BibTeX
@misc{hausknecht2026persistent,
title = {{Persistent Hypertension After Asymptomatic Elevated In-Hospital Blood Pressure: The INDEBP Study}},
author = {K. Hausknecht and M. Mayr and T. Breidthardt and T. Burkard and A. S. Vischer},
howpublished = {medRxiv},
year = {2026},
month = oct,
doi = {10.64898/2026.10.08.26365097},
url = {https://www.medrxiv.org/content/10.64898/2026.10.08.26365097v1},
note = {CC BY-NC-ND},
}
RIS
TY - UNPB
TI - Persistent Hypertension After Asymptomatic Elevated In-Hospital Blood Pressure: The INDEBP Study
AU - K. Hausknecht
AU - M. Mayr
AU - T. Breidthardt
AU - T. Burkard
AU - A. S. Vischer
PY - 2026
DA - 2026/10/08
PB - medRxiv
DO - 10.64898/2026.10.08.26365097
UR - https://www.medrxiv.org/content/10.64898/2026.10.08.26365097v1
AB - BackgroundElevated blood pressure (BP) is common during hospitalization. Despite recommendations to avoid routine changes in antihypertensive therapy, clinical practice remains variable. Prospective data on whether elevated in-hospital BP identifies patients with hypertension after discharge are limited. MethodsAdults hospitalized for non-cardiac conditions with asymptomatic routine in-hospital BP [≥]140 and/or [≥]90 mmHg on at least two occasions separated by [≥]24 hours were prospectively enrolled. Antihypertensive therapy was managed at the discretion of treating physicians. Routine in-hospital BP, standardized research BP, and changes in antihypertensive therapy were recorded. Four weeks after discharge, participants underwent 24-hour ambulatory BP monitoring (ABPM). ResultsAmong 50 participants, 42 (84%; 95% CI, 70.9 - 92.8) had hypertension on follow-up ABPM. Among 21 participants without known hypertension, 18 (86%) had previously unrecognized hypertension on follow-up ABPM; among 29 participants with known hypertension, 24 (83%) had uncontrolled hypertension. Antihypertensive therapy was changed during hospitalization in 26 participants (52%), with de-escalation more frequent than intensification. Hypertension on follow-up ABPM was present in 88.5% of participants with and 79.2% without in-hospital therapy changes. Standardized research BP, but not routine in-hospital BP, correlated with follow-up ABPM. ConclusionAsymptomatic elevated routine in-hospital BP identified a population with a high prevalence of hypertension four weeks after discharge, including patients with and without previously diagnosed hypertension. These findings support structured post-discharge BP reassessment rather than assuming that elevated in-hospital BP is transient. URL: www.ClinicalTrials.gov; Unique identifier: NCT06132451 O_FIG O_LINKSMALLFIG WIDTH=200 HEIGHT=199 SRC="FIGDIR/small/26365097v1_ufig1.gif" ALT="Figure 1"> View larger version (76K): [email protected]@151c2b4org.highwire.dtl.DTLVardef@c5b819org.highwire.dtl.DTLVardef@b98117_HPS_FORMAT_FIGEXP M_FIG C_FIG
ER -