Intensification of older adults’ outpatient blood pressure treatment at hospital discharge: National retrospective cohort study
BMJ Sep 17, 2018
Anderson TS, et al. - In this retrospective cohort study, researchers assessed how often older adults admitted to the hospital for common non-cardiac conditions (pneumonia, urinary tract infection, or venous thromboembolism) were discharged with intensified antihypertensive treatment, as well as identified markers of appropriateness for these intensifications. The retrospective cohort study consisted of patients aged ≥ 65 years with hypertension who were admitted to a hospital with non-cardiac conditions between 2011 and 2013. They found that 1 in 7 older adults were discharged with intensified antihypertensive drugs. Of all patients discharged (n=2,074 [14%]) with intensified antihypertensive treatment, over half had well-controlled blood pressure (BP) levels before admission. Researchers suggested that more attention is required to decrease potentially harmful overtreatment of BP as older adults transition from hospital to home. No differences were observed in rates of intensification among patients least likely to benefit from tight BP control, nor in those most likely to benefit.
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