Hypertension Treatment, Blood Pressure, and Deprescribing Among US Nursing Home Residents With and Without Dementia Before and After the COVID-19 Pandemic.
Sirui Zhang, Andrew R Zullo, Vincent Mor and 4 others
PMID 41022140WHAT IT FOUND
More blood pressure checks after the pandemic did not change average readings or the share of residents with high or low blood pressure.
Residents with dementia had low blood pressure readings, and antihypertensive medicines were reduced less often than in residents without dementia.
Key findings
01Blood pressure measurements per day rose from 1.6 to 1.9 after the pandemic, but average blood pressure values and the share of residents with high or low readings were similar before and after.
02During follow-up, 14.2% of residents with dementia had at least one systolic blood pressure below 90 mm Hg, and 20.9% of those had three or more such readings.
03After 90 days, 14.4% of residents with dementia and 17.9% of residents without dementia had a reduction in antihypertensive medication number or dose lasting at least 7 days.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
It is an observational study, so it cannot show that blood pressure monitoring or medication reduction caused the observed outcomes. Death records were not linked to Medicare data, so mortality outcomes could be misclassified or underestimated. The study did not distinguish residents already taking antihypertensives from those newly starting them, and deprescribing rates may vary by treatment history. Many residents were discharged during follow-up, so the analysis captures only early deprescribing. Facility-level blood pressure monitoring protocols were not accounted for, so measurement frequency and detection of high readings may reflect nursing home practices. It included newly admitted, post-acute nursing home residents, so results may not apply to long-stay or end-of-life residents.
Declared interests
The paper does not include an author disclosure statement. Journal metadata lists NIH extramural and non-U.S. government research support.
The easy way to misread this
Do not conclude that reducing antihypertensive medications in residents with dementia is safe or beneficial. The study observed blood pressure records and medication changes, not a trial of deprescribing, and many residents were discharged during follow-up, so it captures only early deprescribing.