The researchers conclude that more attention is needed to reduce potentially harmful overtreatment of blood pressure as older adults transition from hospital to home.
An editorial notes that the study did not determine whether intensified BP control resulted in drug related harm and the hospital inpatient setting is often a hazardous environment for older adults, where they are exposed to substantial physiological and psychological stress, which may provoke transient exacerbations of chronic diseases, including elevated BP and blood glucose readings in inpatients with hypertension and type 2 diabetes mellitus, respectively. The reflex intensification of drug treatments used to manage these chronic diseases may result in overtreatment after discharge. The editorial adds that this research also underscores the need for more comprehensive and robust medication reconciliation at hospital discharge so that the drugs patients are discharged with should not only be reconciled but also be assessed for correctness and appropriateness, so with regards to intensified antihypertensive treatment during hospital admission, the discharge reconciliation process should include measuring BP before discharge to reassess the need for the intensification, communicating changes in antihypertensive treatment to those responsible for care of patient, and ensuring prompt outpatient follow-up with the patient’s primary care provider.