ArticleJournal of the American Geriatrics Society2023
Systolic blood pressure, antihypertensive treatment, and cardiovascular and mortality risk in VA nursing home residents.
Article in Journal of the American Geriatrics Society, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.
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Who cites it
12 citing papers in PubMed, 1 synthesis or guideline pooled it, 15 citations in OpenAlex.
- Targeting a systolic blood pressure of <130 mmHg is beneficial in adults with hypertension aged ≥75 years: a systematic review and meta-analysis.Hypertension research : official journal of the Japanese Society of Hypertension · 2025Pooled it
- Angiotensin Receptor Blockers Versus Calcium Channel Blockers for First-Line Antihypertensive Therapy and Survival in Adults Aged 75 Years or Older.Journal of the American Geriatrics Society · 2026Article
- Consensus statement on practical guidance for optimizing antihypertensive therapy in older adults needing nursing care by the Japan Geriatrics Society and the Japanese Society of Hypertension: English translation of the Japanese article.Hypertension research : official journal of the Japanese Society of Hypertension · 2026Article
- Consensus Statement on Practical Guidance for Optimizing Antihypertensive Therapy in Older Adults Needing Nursing Care by the Japan Geriatrics Society and the Japanese Society of Hypertension: English Translation of the Japanese Article.Geriatrics & gerontology international · 2026Article
- Prevalence, influencing factors, and preprandial blood pressure management target for postprandial hypotension in older adults with hypertension in long-term care facilities.Hypertension research : official journal of the Japanese Society of Hypertension · 2026Article
- Hypertension research 2024 update and perspectives: blood pressure management.Hypertension research : official journal of the Japanese Society of Hypertension · 2025Review
- Antihypertensive Deprescribing and Functional Status in VA Long-Term Care Residents With and Without Dementia.Journal of the American Geriatrics Society · 2025Article
- Antihypertensive Deprescribing and Cardiovascular Events Among Long-Term Care Residents.JAMA network open · 2024Observational
- Physical performance changes as clues to late-life blood pressure changes with advanced age: the osteoporotic fractures in men study.The journal of nutrition, health & aging · 2024Article
- Association of pulse pressure and mean blood pressure to frailty, sarcopenia, and cognitive dysfunction in elderly outpatients with history of hypertension.Hypertension research : official journal of the Japanese Society of Hypertension · 2024Article
- Disability level's impact on blood pressure-mortality association in older long-term care adults: evidence from a large Chinese cohort study.BMC geriatrics · 2024Article
- We have the technology: Why aren't better blood pressure data available from nursing home residents?Journal of the American Geriatrics Society · 2023Article
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9 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundOptimal systolic BP (SBP) control in nursing home residents is uncertain, largely because this population has been excluded from clinical trials. We examined the association of SBP levels with the risk of cardiovascular (CV) events and mortality in Veterans Affairs (VA) nursing home residents on different numbers of antihypertensive medications.
methodsOur study included 36,634 residents aged ≥65 years with a VA nursing home stay of ≥90 days from October 2006-June 2019. SBP was averaged over the first week after admission and divided into categories. Cause-specific hazard ratios (HRs) of SBP categories with CV events (primary outcome) and all-cause mortality (secondary outcome) were examined using Cox regression and multistate modeling stratified by the number of antihypertensive medications used at admission (0, 1 or 2, and ≥3 medications).
resultsMore than 76% of residents were on antihypertensive therapy and 20% received ≥3 medications. In residents on antihypertensive therapy, a low SBP < 110 mmHg (compared with SBP 130 ~ 149 mmHg) was associated with a greater CV risk (adjusted HR [95% confidence interval]: 1.47 [1.28-1.68] in 1 or 2 medications group, and 1.41 [1.19-1.67] in ≥3 medications group). In residents on no antihypertensives, both low SBP < 110 mmHg and high SBP ≥ 150 mmHg were associated with higher mortality; while in residents receiving any antihypertensives, a low SBP was associated with higher mortality and the highest point estimates were for SBP < 110 mmHg (1.36 [1.28-1.45] in 1 or 2 medications group, and 1.47 [1.31-1.64] in ≥3 medications group).
conclusionsThe associations of SBP with CV and mortality risk varied by the intensity of antihypertensive treatment among VA nursing home residents. A low SBP among those receiving antihypertensives was associated with increased CV and mortality risk, and untreated high SBP was associated with higher mortality. More research is needed on the benefits and harms of SBP lowering in long-term care populations.
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