Many adults with hypertension take BP-raising medications

Source:

Vitarello J, et al. Hypertension management: Insights and opportunities. Presented at: American College of Cardiology Scientific Session; May 15-17, 2021 (virtual meeting).


Disclosures:
The authors report no relevant financial disclosures.


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Nearly 1 in 5 adults with elevated BP also take a medication that could be raising their BP, according to a presentation at the American College of Cardiology Scientific Session.

“If medications that raise BP are common among those with hypertension, this may result in a prescribing cascade whereby patients need more antihypertensive meds to reach BP goals. This study sought to characterize the prevalence of BP-raising meds and those with hypertension and characterize their impact on BP and population control,” John Vitarello, MD, resident in internal medicine at Beth Israel Deaconess Medical Center, said in his presentation.



John Vitarello, MD, resident in internal medicine at Beth Israel Deaconess Medical Center.

In the analysis, researchers identified medications associated with BP elevation based on ACC/American Heart Association guidelines and examined use of the medications by adults with hypertension above and below less than 130/80 mm Hg.

The researchers analyzed data from 27,599 participants in the National Health and Nutrition Examination Survey from 2009 to 2018 (mean age, 56 years, 48% women), of whom 49.2% (95% CI, 48.1-50.4) had hypertension.

Among the cohort, 79.5% (95% CI, 77.3-81.8) had BP above the ACC/AHA goal of 130/80 mm Hg, according to the researchers.

The researchers wrote that of all adults with hypertension, 18.5% used at least one medication known to raise BP.

In the analysis, the most common classes of BP-raising medications among the adults with hypertension were antidepressants (8.7%), NSAIDs (6.5%) and steroids (1.9%).

If half of U.S. adults with hypertension discontinued one BP-raising medication, an additional 2.2 million would reach BP goals, Vitarello said.

In his presentation, Vitarello said the findings suggest that, in some cases, rather than treating high BP with more medications, there may be opportunities to lower BP by discontinuing or substituting safer medications.

“Clinicians should review the prescription and over-the-counter medication use of their patients with hypertension and consider deprescribing of medications that raise BP or seek therapeutic alternatives,” Vitarello said during his presentation.