BP Medication Is Often Intensified At Hospital Discharge

Even patients with well-controlled hypertension often receive intensified blood pressure (BP) treatment when discharged from the hospital, according to the results of a recent study.

Although previous efforts have been made to report changes in drug treatment when discharging patients from the hospital, “comparatively little focus has been placed on the appropriateness of the changes themselves,” the study authors explained.

In order to examine rates of antihypertensive treatment intensification among older adults admitted to the hospital for common non-cardiac conditions, the researchers conducted a retrospective cohort study involving 14,915 patients aged 65 years and older admitted to the hospital between 2011 and 2013.

Among the 14,915 participants, 9636 had well-controlled BP before admission. A total of 20174 were discharged with intensified antihypertensive treatment (1082 of whom had well-controlled BP at admission).

Of those with well-controlled BP, 8% of those without elevated inpatient blood pressure, 24% of those with moderately elevated inpatient blood pressure, and 40% of those with severely elevated inpatient blood pressure were discharged with intensified antihypertensive regimens.

“One in seven older adults admitted to hospital for common non-cardiac conditions were discharged with intensified antihypertensive treatment. More than half of intensifications occurred in patients with previously well-controlled outpatient BP. More attention is needed to reduce potentially harmful overtreatment of blood pressure as older adults transition from hospital to home.”

—Michael Potts

Reference:

Anderson TS, Wray CM, Bocheng J, et al. Intensification of older adults’ outpatient blood pressure treatment at hospital discharge: national retrospective cohort study [published online September 12, 2018]. BMJ. doi: https://doi.org/10.1136/bmj.k3503