Systolic blood pressure levels and mortality in Australian medical inpatients

The epidemiology of elevations in blood pressure is incompletely characterized, particularly in Australia. Given the lack of evidence regarding the frequency and the optimal management of in-hospital hypertension, the authors performed a multicenter retrospective cohort study of consecutive medical admissions in South Australia over a 2-year period to investigate systolic blood pressure levels and their association with in-hospital mortality. Among 16 896 inpatients, 76% had at least one systolic blood pressure reading of ≥140 mmHg and 11.7% of ≥180 mmHg during hospitalization. A statistically significant negative relationship was observed between having at least one reading ≥140 mmHg and a likelihood of in-hospital mortality (odds ratio 0.41, 95% CI: 0.35 to 0.49, P <.001). Our results suggest that elevations in systolic blood pressure are common in Australian medical inpatients. However, the inverse association observed between systolic blood pressure values ≥140 mmHg and in-hospital mortality warrants further research to determine the clinical significance and optimal management of blood pressure elevations in this group.