Intensifying antihypertensive regimens of older adults who were hospitalized for noncardiac conditions is associated with several harms and doesn’t appear to reduce cardiovascular events, a JAMA Internal Medicine study finds.
Using Veterans Affairs’ data, researchers assessed outcomes in patients aged 65 and older with hypertension who were admitted to a VA hospital for pneumonia, urinary tract infection, or venous thromboembolism. Roughly 14% were discharged with intensified antihypertensive regimens — a dose increase of 20% or more. Researchers matched 4100 patients who had treatment intensifications with those who did not.
Thirty-day readmission rates were higher among those with treatment intensification (21% vs. 18%). Those patients also had higher rates of serious adverse events at 30 days (5% vs. 3%). However, cardiovascular events at 1 year were statistically similar between groups (around 13%).
The authors conclude: “Shifting practice from intensifying antihypertensive regimens during hospitalization to communicating concerns about patients’ long-term BP control to outpatient practitioners for close follow-up may provide a safer treatment path for patients.”
Read the article here.
Source: NEJM Journal Watch & JAMA Internal Medicine
