Eldercare clinicians may want to recommend that some nursing home residents reduce or stop the use of blood pressure medications, the authors of a new study have suggested.
Researchers analyzed Medicare data from more than 255,000 U.S. nursing home residents who took medication for high blood pressure. They found that residents taking a greater number of medications to their lower blood pressure were slightly more likely to be hospitalized and hospitalized for heart disease than those taking fewer medications.
Conversely, residents taking more blood pressure medications were slightly less likely to experience declining physical abilities than residents taking fewer. This was true whether or not the residents had dementia, wrote investigator Kenneth Boockvar, M.D.
Overall, however, the results show that residents with high blood pressure do not experience significant benefits from more intensive treatment, wrote Boockvar. “Older adults and their caregivers should be aware that intensive treatment for high blood pressure may not be helpful in long-term nursing home residents. It is reasonable to consider reducing the dose of these drugs or discontinuing their use in residents with dementia, if doing so is consistent with their goals of care,” he concluded.
Beta blockers were the drug most commonly used among the study subjects, followed by calcium channel blockers and angiotensin converting enzyme inhibitors. About half of the subjects were taking more than one high blood pressure drug. Slightly more than half had moderate or severe dementia. Most had moderate functional impairment. Three percent were receiving hospice care. The study subjects’ average age was 85.
About 27% of older adult nursing home residents in the United States have both high blood pressure and dementia.
Read more about the study