HealthDay News — For older adults with hypertension receiving at least 1 antihypertensive medication at less than the maximum dose, intensification with the addition of a new medication is associated with less intensification sustainability and a slightly larger reduction in mean systolic blood pressure (SBP) than maximizing the dose, according to a study published online October 5 in the Annals of Internal Medicine.

Carole E. Aubert, MD, from Bern University Hospital in Switzerland, and colleagues examined the frequency of intensification by adding a new medication vs maximizing the dose in a large-scale, population-based retrospective cohort study. Data were included for veterans aged 65 years or older with hypertension, SBP of at least 130mmHg, and at least 1 antihypertensive medication at less than the maximum dose. Among 178,562 patients, 25.5 and 74.5% had intensification by adding a new medication and maximizing the dose, respectively.

The researchers found that at 3 months and 12 months, adding a new medication was associated with less intensification sustainability (average treatment effect, −15.2 and −15.1%, respectively) and a larger reduction in mean SBP (−0.8 and −1.1mmHg, respectively) compared with maximizing the dose.

“Adding a new medication was associated with greater SBP reduction but less frequent sustained intensification, possibly suggesting that adverse drug events might be more common or patients less willing to take additional medications,” the authors write.


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