With important exceptions, hypertension (high blood pressure) is well-controlled in nursing homes run by the U.S. Veterans Administration, a new study finds. 

Poor control of hypertension — both under- and overtreatment — can cause preventable adverse events in long-term care residents, the authors noted. To gauge treatment and control over time, investigators examined data from 2006 through 2018 for more than 40,000 VA facility residents using the VA’s electronic health record and Bar Code Medication Administration system. Study participants were aged 65 years and older.

Rates of hypertension at admission grew over time (from 75% to 85%), the researchers found. But blood pressure treatment and control remained high over the study period. Fully 80% of residents with hypertension were treated in fiscal year 2017-2018, and 80% had average blood pressure lower than 140/90 mmHg, they reported.

Notably, the age-adjusted prevalence of chronic low blood pressure (less than 90/60 mmHg) declined during the study period, from 11% to 4.7%. This reduced prevalence may be linked to a recent trend encouraging less intensive blood pressure control, they wrote.

Despite the overall positive trends, some resident groups were less likely to maintain average optimal levels. These included residents who identified as Black or having Hispanic ethnicity and residents with a history of diabetes or renal disease, the researchers reported.

Full findings were published in the Journal of the American Geriatrics Society.

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