by Lori Solomon

Deprescribing antihypertensive medication is not associated with the risk for hospitalization for myocardial infarction (MI) or stroke in long-term care residents, according to a study published online Nov. 25 in JAMA Network Open.

Michelle C. Odden, Ph.D., from Stanford University in California, and colleagues compared the incidence of hospitalization for MI or stroke among long-term care residents who are deprescribed or continue antihypertensive therapy. The analysis included 13,096 U.S. veterans residing in long-term care (Oct. 1, 2006, to Sept. 30, 2019) taking at least one antihypertensive medication.

The researchers found that 17.8 percent of veterans were deprescribed antihypertensive medication during a period of 12 weeks. Over two years, a similar estimated unadjusted cumulative incidence of stroke or MI hospitalization was seen for residents who were and were not deprescribed antihypertensives (11.2 versus 8.8 percent). In fully adjusted models, the per-protocol analysis results showed no association of antihypertensive deprescribing with MI or stroke hospitalization (hazard ratio, 0.93; 95 percent confidence interval, 0.70 to 1.26).

"A randomized clinical trial would help address concerns about unmeasured confounding but could be challenging to implement in this complex population," the authors write. "More research is needed on deprescribing methods and potential consequences to inform this growing practice and inform patient and clinician shared decision-making."

More information: Michelle C. Odden et al, Antihypertensive Deprescribing and Cardiovascular Events Among Long-Term Care Residents, JAMA Network Open (2024). DOI: 10.1001/jamanetworkopen.2024.46851

Julie C. Lauffenburger, Moving Deprescribing Beyond Potentially Harmful Medications, JAMA Network Open (2024). DOI: 10.1001/jamanetworkopen.2024.46857

Journal information: JAMA Network Open 

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