{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T15:49:57Z","timestamp":1786549797947,"version":"build-2736575974"},"reference-count":43,"publisher":"American Medical Association (AMA)","issue":"8","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Surg"],"published-print":{"date-parts":[[2026,8,1]]},"abstract":"<jats:sec id=\"ab-srv260002-1\">\n                    <jats:title>Importance<\/jats:title>\n                    <jats:p>Asymptomatic postoperative hypertension is a common clinical condition in admitted surgical patients. As-needed treatment with medication to acutely lower measured systolic blood pressure can have adverse outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-srv260002-2\">\n                    <jats:title>Observations<\/jats:title>\n                    <jats:p>Existing literature and current practice guidelines indicate that treating asymptomatic hypertension can lead to adverse clinical outcomes. Because of systematic triggers, including nursing notifications, unfamiliarity with perioperative medical studies, and as-needed medication orders, it is often treated in the postoperative period.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-srv260002-3\">\n                    <jats:title>Conclusions and Relevance<\/jats:title>\n                    <jats:p>Postoperative hypertension should only be treated when it is symptomatic. A conscientious effort should be made to minimize systematic triggers that lead to unnecessary treatment.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1001\/jamasurg.2026.2059","type":"journal-article","created":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T15:30:32Z","timestamp":1781710232000},"page":"840","source":"Crossref","is-referenced-by-count":0,"title":["As-Needed Treatment of Postoperative Hypertension for Inpatient Surgical Patients"],"prefix":"10.1001","volume":"161","author":[{"given":"Baylee F.","family":"Bakkila","sequence":"first","affiliation":[{"name":"Department of Surgery, Stanford University School of Medicine, Stanford, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sherry M.","family":"Wren","sequence":"additional","affiliation":[{"name":"Department of Surgery, Stanford University School of Medicine, Stanford, California"},{"name":"Veterans Affairs Palo Alto Health Care System, Palo Alto, California"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","reference":[{"key":"srv260002r1","article-title":"Hypertension prevalence, awareness, treatment, and control among adults age 18 and older: United States, August 2021-August 2023.","volume":"511","author":"Fryar","year":"2024","journal-title":"NCHS Data Brief"},{"issue":"12","key":"srv260002r2","first-page":"763","article-title":"Hypertension: new guidelines from the International Society of Hypertension.","volume":"103","author":"Buelt","year":"2021","journal-title":"Am Fam Physician"},{"issue":"6","key":"srv260002r3","doi-asserted-by":"publisher","first-page":"1148","DOI":"10.1097\/HJH.0000000000002021","article-title":"The global burden of hypertension exceeds 1.4 billion people: should a systolic blood pressure target below 130 become the universal standard?","volume":"37","author":"Egan","year":"2019","journal-title":"J Hypertens"},{"issue":"10296","key":"srv260002r4","doi-asserted-by":"publisher","first-page":"249","DOI":"10.1016\/S0140-6736(21)00221-X","article-title":"Arterial hypertension.","volume":"398","author":"Brouwers","year":"2021","journal-title":"Lancet"},{"issue":"7","key":"srv260002r5","doi-asserted-by":"publisher","first-page":"417","DOI":"10.1002\/jhm.804","article-title":"Prevalence and management of hypertension in the inpatient setting: a systematic review.","volume":"6","author":"Axon","year":"2011","journal-title":"J Hosp Med"},{"issue":"8","key":"srv260002r6","doi-asserted-by":"publisher","first-page":"e94","DOI":"10.1161\/HYP.0000000000000238","article-title":"The management of elevated blood pressure in the acute care setting: a scientific statement from the American Heart Association.","volume":"81","author":"Bress","year":"2024","journal-title":"Hypertension"},{"issue":"4","key":"srv260002r7","doi-asserted-by":"publisher","first-page":"550","DOI":"10.1097\/ALN.0000000000002626","article-title":"Incidence, severity, and detection of blood pressure perturbations after abdominal surgery: a prospective blinded observational study.","volume":"130","author":"Turan","year":"2019","journal-title":"Anesthesiology"},{"issue":"16","key":"srv260002r8","doi-asserted-by":"publisher","first-page":"1661","DOI":"10.1093\/ajhp\/61.16.1661","article-title":"Acute postoperative hypertension: a review of therapeutic options.","volume":"61","author":"Haas","year":"2004","journal-title":"Am J Health Syst Pharm"},{"issue":"10","key":"srv260002r9","doi-asserted-by":"publisher","first-page":"1982","DOI":"10.1097\/HJH.0000000000002872","article-title":"Relation between elevated first SBP from baseline (delta SBP) and postoperative outcome.","volume":"39","author":"Zhou","year":"2021","journal-title":"J Hypertens"},{"issue":"8","key":"srv260002r10","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.89308","article-title":"Prevalence of white coat hypertension among surgical patients at a tertiary care hospital: a cross-sectional observational study.","volume":"17","author":"Shah","year":"2025","journal-title":"Cureus"},{"issue":"3","key":"srv260002r11","doi-asserted-by":"publisher","first-page":"315","DOI":"10.1097\/01.aco.0000192811.56161.23","article-title":"Hypertension and anesthesia.","volume":"19","author":"Hanada","year":"2006","journal-title":"Curr Opin Anaesthesiol"},{"issue":"7","key":"srv260002r12","doi-asserted-by":"publisher","first-page":"219","DOI":"10.15585\/mmwr.mm6707a4","article-title":"Prevalence of self-reported hypertension and antihypertensive medication use among adults aged =18 Years - United States, 2011-2015.","volume":"67","author":"Fang","year":"2018","journal-title":"MMWR Morb Mortal Wkly Rep"},{"issue":"5","key":"srv260002r13","doi-asserted-by":"publisher","first-page":"e35","DOI":"10.1161\/HYP.0000000000000087","article-title":"Measurement of blood pressure in humans: a scientific statement from the American Heart Association.","volume":"73","author":"Muntner","year":"2019","journal-title":"Hypertension"},{"issue":"9","key":"srv260002r14","doi-asserted-by":"publisher","DOI":"10.1088\/1361-6579\/ac890e","article-title":"Sources of automatic office blood pressure measurement error: a systematic review.","volume":"43","author":"Liu","year":"2022","journal-title":"Physiol Meas"},{"issue":"10","key":"srv260002r15","doi-asserted-by":"publisher","first-page":"e212","DOI":"10.1161\/HYP.0000000000000249","article-title":"2025 AHA\/ACC\/AANP\/AAPA\/ABC\/ACCP\/ACPM\/AGS\/AMA\/ASPC\/NMA\/PCNA\/SGIM guideline for the prevention, detection, evaluation and management of high blood pressure in adults: a report of the American College of Cardiology\/American Heart Association Joint Committee on Clinical Practice Guidelines.","volume":"82","author":"Writing Committee Members","year":"2025","journal-title":"Hypertension"},{"key":"srv260002r16","doi-asserted-by":"publisher","DOI":"10.1155\/2014\/353628","article-title":"Noninvasive techniques for blood pressure measurement are not a reliable alternative to direct measurement: a randomized crossover trial in ICU.","volume":"2014","author":"Ribezzo","year":"2014","journal-title":"ScientificWorldJournal"},{"issue":"3","key":"srv260002r17","doi-asserted-by":"publisher","first-page":"421","DOI":"10.1097\/HJH.0000000000001197","article-title":"Sources of inaccuracy in the measurement of adult patients\u2019 resting blood pressure in clinical settings: a systematic review.","volume":"35","author":"Kallioinen","year":"2017","journal-title":"J Hypertens"},{"issue":"5","key":"srv260002r18","doi-asserted-by":"publisher","first-page":"973","DOI":"10.1097\/ALN.0b013e3182330286","article-title":"Invasive and concomitant noninvasive intraoperative blood pressure monitoring: observed differences in measurements and associated therapeutic interventions.","volume":"115","author":"Wax","year":"2011","journal-title":"Anesthesiology"},{"issue":"2","key":"srv260002r19","doi-asserted-by":"publisher","first-page":"474","DOI":"10.1213\/01.ANE.0000155970.45321.A8","article-title":"The efficacy and safety of pain management before and after implementation of hospital-wide pain management standards: is patient safety compromised by treatment based solely on numerical pain ratings?","volume":"101","author":"Vila","year":"2005","journal-title":"Anesth Analg"},{"issue":"12","key":"srv260002r20","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2023.49136","article-title":"Electronic health record messaging patterns of health care professionals in inpatient medicine.","volume":"6","author":"Small","year":"2023","journal-title":"JAMA Netw Open"},{"key":"srv260002r21","doi-asserted-by":"publisher","DOI":"10.2196\/48583","article-title":"Characterizing the patterns of electronic health record-integrated secure messaging use: cross-sectional study.","volume":"25","author":"Baratta","year":"2023","journal-title":"J Med Internet Res"},{"issue":"19","key":"srv260002r22","doi-asserted-by":"publisher","first-page":"1869","DOI":"10.1016\/j.jacc.2024.06.013","article-title":"2024 AHA\/ACC\/ACS\/ASNC\/HRS\/SCA\/SCCT\/SCMR\/SVM guideline for perioperative cardiovascular management for noncardiac surgery: a report of the American College of Cardiology\/American Heart Association Joint Committee on Clinical Practice Guidelines.","volume":"84","author":"Thompson","year":"2024","journal-title":"J Am Coll Cardiol"},{"issue":"18","key":"srv260002r23","doi-asserted-by":"publisher","first-page":"1567","DOI":"10.1016\/j.jacc.2025.05.007","article-title":"2025 AHA\/ACC\/AANP\/AAPA\/ABC\/ACCP\/ACPM\/AGS\/AMA\/ASPC\/NMA\/PCNA\/SGIM guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: a report of the American College of Cardiology\/American Heart Association Joint Committee on Clinical Practice Guidelines.","volume":"86","author":"Jones","year":"2025","journal-title":"J Am Coll Cardiol"},{"issue":"5","key":"srv260002r24","doi-asserted-by":"publisher","first-page":"289","DOI":"10.1002\/jhm.2182","article-title":"Thirty-day mortality risk associated with the postoperative nonresumption of angiotensin-converting enzyme inhibitors: a retrospective study of the Veterans Affairs Healthcare System.","volume":"9","author":"Mudumbai","year":"2014","journal-title":"J Hosp Med"},{"issue":"2","key":"srv260002r25","doi-asserted-by":"publisher","first-page":"288","DOI":"10.1097\/ALN.0000000000000739","article-title":"Association between withholding angiotensin receptor blockers in the early postoperative period and 30-day mortality: a cohort study of the Veterans Affairs healthcare system.","volume":"123","author":"Lee","year":"2015","journal-title":"Anesthesiology"},{"issue":"19","key":"srv260002r26","doi-asserted-by":"publisher","first-page":"1843","DOI":"10.1056\/NEJMcp1901117","article-title":"Acute severe hypertension.","volume":"381","author":"Peixoto","year":"2019","journal-title":"N Engl J Med"},{"issue":"6","key":"srv260002r27","doi-asserted-by":"publisher","first-page":"e13","DOI":"10.1161\/HYP.0000000000000065","article-title":"2017 ACC\/AHA\/AAPA\/ABC\/ACPM\/AGS\/APhA\/ASH\/ASPC\/NMA\/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: a report of the American College of Cardiology\/American Heart Association Task Force on Clinical Practice Guidelines.","volume":"71","author":"Whelton","year":"2018","journal-title":"Hypertension"},{"issue":"4","key":"srv260002r28","doi-asserted-by":"publisher","first-page":"599","DOI":"10.1016\/j.ahj.2009.07.020","article-title":"Practice patterns, outcomes, and end-organ dysfunction for patients with acute severe hypertension: the Studying the Treatment of Acute hyperTension (STAT) registry.","volume":"158","author":"Katz","year":"2009","journal-title":"Am Heart J"},{"issue":"6","key":"srv260002r29","doi-asserted-by":"publisher","first-page":"R271","DOI":"10.1186\/cc10551","article-title":"Characteristics, practice patterns, and outcomes in patients with acute hypertension: European Registry for Studying the Treatment of Acute Hypertension (Euro-STAT).","volume":"15","author":"Vuylsteke","year":"2011","journal-title":"Crit Care"},{"issue":"10","key":"srv260002r30","doi-asserted-by":"publisher","first-page":"2330","DOI":"10.1097\/CCM.0b013e3182227238","article-title":"Clinical practices, complications, and mortality in neurological patients with acute severe hypertension: the Studying the Treatment of Acute Hypertension registry.","volume":"39","author":"Mayer","year":"2011","journal-title":"Crit Care Med"},{"issue":"1","key":"srv260002r31","doi-asserted-by":"publisher","first-page":"52","DOI":"10.1001\/jamainternmed.2024.6213","article-title":"As-needed blood pressure medication and adverse outcomes in VA hospitals.","volume":"185","author":"Canales","year":"2025","journal-title":"JAMA Intern Med"},{"issue":"2","key":"srv260002r32","doi-asserted-by":"publisher","first-page":"250","DOI":"10.1177\/000313481207800247","article-title":"As-needed antihypertensive therapy in surgical patients, why and how: challenging a paradigm.","volume":"78","author":"Miller","year":"2012","journal-title":"Am Surg"},{"issue":"1","key":"srv260002r33","doi-asserted-by":"publisher","first-page":"29","DOI":"10.1111\/j.1751-7176.2009.00196.x","article-title":"Treatment of hypertension in the inpatient setting: use of intravenous labetalol and hydralazine.","volume":"12","author":"Weder","year":"2010","journal-title":"J Clin Hypertens (Greenwich)"},{"issue":"1","key":"srv260002r34","doi-asserted-by":"publisher","first-page":"18","DOI":"10.1161\/HYPERTENSIONAHA.110.164194","article-title":"Treating acute hypertension in the hospital: a lacuna in the guidelines.","volume":"57","author":"Weder","year":"2011","journal-title":"Hypertension"},{"issue":"9","key":"srv260002r35","doi-asserted-by":"publisher","first-page":"698","DOI":"10.1111\/j.1751-7176.2010.00309.x","article-title":"Attitudes and practices of resident physicians regarding hypertension in the inpatient setting.","volume":"12","author":"Axon","year":"2010","journal-title":"J Clin Hypertens (Greenwich)"},{"issue":"2","key":"srv260002r36","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0263737","article-title":"The burden of perioperative hypertension\/hypotension: a systematic review.","volume":"17","author":"Lizano-D\u00edez","year":"2022","journal-title":"PLoS One"},{"issue":"11","key":"srv260002r37","doi-asserted-by":"publisher","first-page":"1528","DOI":"10.1001\/jamainternmed.2019.3007","article-title":"Clinical outcomes after intensifying antihypertensive medication regimens among older adults at hospital discharge.","volume":"179","author":"Anderson","year":"2019","journal-title":"JAMA Intern Med"},{"issue":"4","key":"srv260002r38","doi-asserted-by":"publisher","first-page":"357","DOI":"10.1097\/00005792-197807000-00006","article-title":"Cardiac risk factors and complications in non-cardiac surgery.","volume":"57","author":"Goldman","year":"1978","journal-title":"Medicine (Baltimore)"},{"issue":"5","key":"srv260002r39","doi-asserted-by":"publisher","first-page":"567","DOI":"10.1097\/00000658-199011000-00003","article-title":"Intraoperative blood pressure: what patterns identify patients at risk for postoperative complications?","volume":"212","author":"Charlson","year":"1990","journal-title":"Ann Surg"},{"issue":"2","key":"srv260002r40","doi-asserted-by":"publisher","first-page":"273","DOI":"10.1213\/00000539-200208000-00003","article-title":"Intraoperative tachycardia and hypertension are independently associated with adverse outcome in noncardiac surgery of long duration.","volume":"95","author":"Reich","year":"2002","journal-title":"Anesth Analg"},{"key":"srv260002r41","doi-asserted-by":"publisher","first-page":"k3503","DOI":"10.1136\/bmj.k3503","article-title":"Intensification of older adults\u2019 outpatient blood pressure treatment at hospital discharge: national retrospective cohort study.","volume":"362","author":"Anderson","year":"2018","journal-title":"BMJ"},{"issue":"4","key":"srv260002r42","doi-asserted-by":"publisher","first-page":"504","DOI":"10.1161\/01.HYP.21.4.504","article-title":"National standard for measurement of resting and ambulatory blood pressures with automated sphygmomanometers.","volume":"21","author":"White","year":"1993","journal-title":"Hypertension"},{"issue":"4","key":"srv260002r43","doi-asserted-by":"publisher","first-page":"194","DOI":"10.12788\/jfp.0188","article-title":"Automated office BP measurement: the new standard in HTN screening.","volume":"70","author":"Tiglao","year":"2021","journal-title":"J Fam Pract"}],"container-title":["JAMA Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/jamanetwork.com\/journals\/jamasurgery\/articlepdf\/2850514\/jamasurgery_bakkila_2026_rv_260002_1785955372.89394.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T15:00:48Z","timestamp":1786546848000},"score":1,"resource":{"primary":{"URL":"https:\/\/jamanetwork.com\/journals\/jamasurgery\/fullarticle\/2850514"}},"subtitle":["A Review"],"short-title":[],"issued":{"date-parts":[[2026,8,1]]},"references-count":43,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2026,8,1]]}},"URL":"https:\/\/doi.org\/10.1001\/jamasurg.2026.2059","relation":{},"ISSN":["2168-6254"],"issn-type":[{"value":"2168-6254","type":"print"}],"subject":[],"published":{"date-parts":[[2026,8,1]]}}}