(HealthDay News) — Increasing blood pressure medications at hospital discharge for elderly patients hospitalized with noncardiac conditions does not improve long-term outcomes and is tied to short-term harms, according to a study published online in JAMA Internal Medicine.
Timothy S. Anderson, MD, from University of California in San Francisco, and colleagues examined the association between intensification of antihypertensive regimens at hospital discharge and clinical outcomes after discharge among older patients (mean age, 77 years; 97.7% male) with hypertension who were hospitalized for common noncardiac conditions in Veterans Health Administration national health system facilities from 2011 through 2013.
The researchers found that within 30 days, patients receiving intensifications had a higher risk for readmission (hazard ratio [HR], 1.23 [95% confidence interval (CI), 1.07 to 1.42]; number needed to harm [NNH], 27 [95% CI, 16 to 76]) and serious adverse events (HR, 1.41 [95% CI, 1.06 to 1.88]; NNH, 63 [95% CI, 34 to 370]). Compared with those not receiving intensification, at one year, there were no differences in cardiovascular events (HR, 1.18; 95% CI, 0.99 to 1.40) or change in systolic blood pressure (mean blood pressure, 134.7 vs 134.4; difference-in-differences estimate, 0.6 mm Hg; 95% CI, −2.4 to 3.7 mm Hg).
“The findings suggest that intensification of antihypertensives at hospital discharge is associated with short-term harms without long-term benefits, and should generally be avoided in older adults hospitalized for noncardiac conditions,” the authors write.
Anderson TS, Jing B, Auerbach A, et al. Clinical Outcomes After Intensifying Antihypertensive Medication Regimens Among Older Adults at Hospital Discharge. JAMA Intern Med. (Published online August 19, 2019.) doi:10.1001/jamainternmed.2019.3007