Deprescribing antihypertensive medication not tied to risk of stroke or MI hospitalization in long-term care: JAMA

The key findings were:

• The study comprised 13,096 long-term care residents, whose median age was 77 years (IQR, 70-84 years). Of these, 97.4% were men.

• Of the residents, 17.8% of them had their antihypertensive medication deprescribed in a period exceeding 12 weeks.

• The unadjusted cumulative incidence of MI or stroke hospitalization within two years for those deprescribed was 11.2%, and for the continued therapy, it was 8.8% (difference: 2.4 percentage points; 95% CI: −2.3 to 7.1).

• After full adjustment, there was no significant association between deprescribing and increased risk of MI or stroke (hazard ratio: 0.93; 95% CI: 0.70-1.26).

• The participant characteristics were well-balanced after applying IPTW and IPCW, with standardized mean differences of less than 0.05 for all variables.

In older residents of long-term care facilities, deprescribing antihypertensive drugs did not increase the risk for hospitalization for acute MI or stroke. The results support the safe introduction of deprescribing in elderly populations, providing clinicians with a data-driven strategy for minimizing the burden of medications without loss of cardiovascular safety.

Reference:

Odden, M. C., Graham, L. A., Liu, X., Dave, C. V., Lee, S. J., Li, Y., Jing, B., Fung, K., Peralta, C. A., & Steinman, M. A. (2024). Antihypertensive deprescribing and cardiovascular events among long-term care residents. JAMA Network Open, 7(11), e2446851. https://doi.org/10.1001/jamanetworkopen.2024.46851