The use of blood pressure (BP)-interfering medications appears to be prevalent among patients with hypertension who require antihypertensive intensification, according to a study published in American Journal of Hypertension.

To better understand the real-world use of these agents among patients with hypertension, researchers conducted a retrospective drug utilization study using medical and prescription claims from the Marketscan database (January 2008 to December 2014). The study included adult patients with hypertension who had filled ≥1 antihypertensive drug; these patients were then separated into 2 cohorts: new antihypertensive users (incident hypertension; N=521,028) and those who required titration to a 4th antihypertensive (incident treatment-resistant hypertension [TRH]; N=131,764). Exposure to BP-interfering drugs was assessed at 6 months before and after the index date (defined as the first antihypertensive fill or the first occurrence of overlapping use of ≥4 antihypertensives).

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Results showed that nonsteroidal anti-inflammatory drugs (NSAIDs), acetaminophen and hormone medications were the most commonly filled BP-interfering medications in both cohorts. A similar proportion of patients in the incident hypertension cohort and incident TRH cohort started a BP-interfering medication after the index date (18.3% and 17.6%, respectively). Moreover, in both cohorts, over half of the patients who were previously taking a BP-interfering medication refilled that medication after antihypertensive intensification (57.6% and 64.9%, respectively).

“Greater efforts to limit the use of these medications, where feasible, may be required among patients with uncontrolled hypertension,” the authors concluded. They added that “incorporating systematic processes to identify BP-interfering medications during routine follow-up may be beneficial […], particularly for patients with more difficult to control BP.”

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