Hypertension is prevalent in the population at large and among hospitalized patients. Little has been reported regarding the attitudes and patterns of care of physicians managing nonemergent elevated blood pressure (BP) among inpatients. Resident physicians in internal medicine (IM), family medicine (FM), and surgery were surveyed regarding inpatient BP management. One hundred eighty-one questionnaires were completed across 3 sites. Respondents generally considered inpatient BP control a high priority. A majority of IM and FM residents indicated following the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7) consensus guidelines for inpatients compared to 20% of surgery residents (P<.001). While trainees did not appear to strictly follow JNC 7 guidelines for goal BP of 140 ⁄ 90 mm Hg, they did report making frequent BP medication changes (51% reported changing regimens for >50% of hypertensive patients). Overall 90% indicated that discharging a hypertensive patient on a drug regimen established during hospitalization is preferable to reverting to the regimen in place at the time of admission. Resident physicians regard elevated BP inpatient management as important, but attitudes and practice vary between specialties. JNC 7 guidelines may not be appropriate for inpatient use. Future research should focus on developing functional diagnostic criteria for hypertension in the inpatient setting and determining best practices inpatient BP management. J Clin Hypertens (Greenwich). 2010;12:698-705. W hile guidelines for hypertension management and studies of control efforts over the past 30 years have fittingly concentrated on the outpatient setting, evidence suggests that the prevalence of hypertension in the inpatient setting is as high as 50%.1 Hospitalization is common in the United States. In 2002, there were more than 38 million inpatient hospitalizations and roughly 33 million additional surgical procedures among adults.2,3 Available studies indicate that recognition and control of hypertension in the inpatient setting are suboptimal, even in patients with high-risk conditions such as ischemic heart disease and stroke.4-10 Thus, the inpatient setting might reasonably be a site to focus efforts to improve hypertension treatment.While experts generally agree on principles for treatment of the range of hypertensive emergency