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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.
Citation:

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.

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