Comparing Outcomes between Thiazide Diuretics and Other First-Line Antihypertensive Drugs in Long-term Nursing Home Residents.

The objectives of this study were to describe the patterns of antihypertensive medication treatment in this population, focusing on thiazide diuretics, and to determine the association between thiazide diuretics (DIURs) and outcomes important to NH patients. METHODS: This observational cohort study was conducted in long-term NH residents treated for hypertension in the second quarter (Q2) of 2013, from all US NHs. The primary exposure was the frequency of use of antihypertensive treatment class (DIURs, angiotensin-converting enzyme inhibitors, angiotensin receptor blockers [ARBs], calcium channel blockers, and β-blockers) according to Medicare Part D dispensing data. Because DIUR-related urinary symptoms were a focus, residents receiving nonthiazide diuretics were excluded. We ascertained continued medication use by class from Q2 to Q4 of 2013, and ascertained 6-month incontinence and hospitalization using data from Medicare claims and the Minimum Data Set. FINDINGS: Of 152,902 NH residents treated for hypertension, 52.2% were treated with β-blockers (22% as a single agent), 39.7% with calcium channel blockers (14% as a single agent), 38.8% with angiotensin-converting enzyme inhibitors (14% as a single agent), 14.2% with DIURs (2% as a single agent), and 13.2% with ARBs (4% as a single agent). Overall, 55.1% were treated with 1 drug; 33.2%, with 2 drugs; and 11.8%, with 3 or more drugs. From Q2 to Q4, DIURs were more likely to have been discontinued than any...
Source: Clinical Therapeutics - Category: Drugs & Pharmacology Authors: Tags: Clin Ther Source Type: research