Do I need to treat supine hypertension in my hospitalized patient?

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TABLE 1

Criteria for blood pressure (BP) measurement

Measurement steps	Criteria
Patient preparation	The patient should avoid exercise or consuming caffeine, alcohol, or nicotine for at least 30 minutes before measurement Ensure the patient has emptied their bladder Muscle tension, talking, background noise, pain, and psychological processes (eg, fear, anxiety) may impact BP measurement
Equipment	Use a BP measurement device that has been validated and is calibrated regularly Ensure proper cuff size is used, ideally with bladder length that is 80% of arm circumference
Patient position	The patient’s back should be supported and legs uncrossed; the patient’s arm should be supported Remove clothing covering the location of cuff placement; the middle of the cuff should be positioned on the patient’s upper arm at the level of the right atrium (midpoint of the sternum)
Number of measurements	Check BP in both arms at the first examination; if there is a consistent interarm difference, use the arm with the higher pressure Take a minimum of 2 readings at intervals of at least 1 minute and average them to represent the patient’s BP If there is > 5 mm Hg difference between the first and second readings, obtain additional readings and average them to represent the patient’s BP