BP Diagnosis, Control, and Treatment Among VA Nursing Home Residents

Findings show hypertension is well controlled among residents in US Department of Veterans Affairs (VA) nursing homes (NHs) and lower prevalence of chronic low blood pressure (BP) was connected to recent trends of less intensive BP control; however, some high-risk populations still report average BP levels >140/90 mmHg.

Researchers noted preventable adverse events in NH residents can be a result of inadequate treatment of high BP and excessive treatment can also lead to associated harms.

Study authors reviewed data for 40,079 long-term care residents aged 65 years and older from October 2006 through September 2018 (FY2007-2018) from the VA electronic health record and Bar Code Medication Administration system.

An increase from 75.2% in FY2007-2008 to 85.1% in FY2017-2018 (P-value for trend < .001) was reported as the age-standardized prevalence of hypertension diagnosis at admission.

"Rates of BP treatment and control among residents with hypertension at admission declined slightly over time (P-values for trend < .001) but remained high (80.3% treated in FY2017-2018, 80.1% with average BP <140/90 mmHg),” wrote researchers.

A decline of age-adjusted prevalence of chronic low BP (average <90/60 mmHg) was also reported from 11.1% in FY2007-2008 to 4.7% in FY2017-2018 (P-value trend for < .001).

Patients with a history of diabetes, stroke, and renal disease as well as persons identified as Black race or Hispanic ethnicity were less likely to have an average BP <140/90 mmHg.

“Future research is needed to better understand the benefits and harms of BP control in nursing home residents,” concluded study authors.

Reference:
Odden MC, Li Y, Graham LA, et al. Trends in blood pressure diagnosis, treatment and control among VA nursing home residents, 2007-2018. J Am Geriatr Soc. Published online May 7, 2022. doi:10.1111/jgs.17821