HTN Tx Intensification Common Upon Discharge in U.S. Vets
Fourteen percent of older adults admitted to hospital for non-cardiac conditions had intensification of tx
WEDNESDAY, Sept. 19, 2018 (HealthDay News) -- Fourteen percent of older adults hospitalized with non-cardiac conditions are discharged with intensified antihypertensive treatment, of whom more than half had previously well-controlled outpatient blood pressure, according to a study published online Sept. 12 in The BMJ.
Timothy S. Anderson, M.D., from the University of California in San Francisco, and colleagues conducted a retrospective cohort study involving 14,915 older adults with hypertension admitted to the VA hospital with non-cardiac conditions between 2011 and 2013.
The researchers found that 65 percent of the participants had well-controlled outpatient blood pressure before admission to the hospital. Fourteen percent of patients were discharged with intensified antihypertensive treatment, more than half of whom had well-controlled blood pressure prior to hospital admission. There was a strong correlation for elevated inpatient blood pressure with being discharged on intensified antihypertensive regimens, after adjustment for potential confounders. For patients with previously well-controlled outpatient blood pressure, discharge with intensified antihypertensive regimens occurred among 8, 24, and 40 percent of patients without elevated inpatient blood pressure, with moderately elevated inpatient blood pressure, and with severely elevated inpatient blood pressure, respectively. The rates of intensification were no different for patients least likely to benefit from tight blood pressure control or those most likely to benefit.
"More attention is needed to reduce potentially harmful overtreatment of blood pressure as older adults transition from hospital to home," the authors write.