Hospital Discharge Prescription of Drugs That May Raise Blood Pressure in Patients With Hypertension.

PURPOSE

This study aimed to determine the frequency of discharge prescriptions of drugs that may raise blood pressure (BP) in hospitalized patients with hypertension and identify factors associated with these prescriptions.

METHODS

A retrospective cross-sectional analysis was conducted using a nationwide inpatient database in Japan, focusing on adults with hypertension discharged from acute care hospitals between April 2021 and March 2022. The primary outcome was the prescription of drugs that may raise BP at discharge. A multivariable linear probability model was employed to assess the relationship between patient and hospital characteristics and the likelihood of receiving these prescriptions.

RESULTS

Among 979 234 patients with hypertension (mean age: 75.3 years, standard deviation: 13.2), 230 792 (23.6%) received at least one drug that may elevate BP at discharge. Non-steroidal anti-inflammatory drugs (NSAIDs) were the most frequently prescribed (46.6%), followed by glucocorticoids (35.3%), atypical antipsychotics (15.1%), antidepressants (7.9%), and Japanese herbal medicines (6.1%). Prescription prevalence was higher among female patients, younger adults, those admitted for medical conditions, non-emergency hospitalizations, patients with disabilities, and those with a Charlson Comorbidity Index of 1. Patients hospitalized for musculoskeletal or skin conditions, transferred to another hospital, or discharged from high-volume hospitals were also more likely to receive these prescriptions.

CONCLUSIONS

Drugs that may raise BP are commonly prescribed at discharge for patients with hypertension. This highlights the need for targeted interventions to optimize medication management at discharge, aiming to improve BP control and patient outcomes.