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Intensification of BP Treatment Upon Discharge

BMJ; ePub 2018 Sep 12; Anderson, Wray, et al

Among older adults admitted to hospital for common non-cardiac conditions, 1 in 7 were discharged with intensified antihypertensive treatment and more than half of intensifications occurred in patients with previously well controlled outpatient blood pressure (BP). This according to a national retrospective cohort study of patients (aged ≥65 years) with hypertension admitted to US Veterans Affairs hospitals with non-cardiac conditions between 2011 and 2013. Researchers found:

  • Among 14,915 older adults (median age 76 years), 9,636 (65%) had well controlled outpatient BP before hospital admission.
  • Overall, 2,074 (14%) patients were discharged with intensified antihypertensive treatment, more than half of whom had well controlled BP before admission.
  • Elevated inpatient BP was strongly associated with being discharged on intensified antihypertensive regimens.
  • No differences were seen in rates of intensification among patients least likely to benefit from tight BP control.


Anderson TS, Wray CM, Jing B, et al. Intensification of older adults’ outpatient blood pressure treatment at hospital discharge: National retrospective cohort study. [Published online ahead of print September 12, 2018]. BMJ. doi:10.1136/bmj.k3503.