C Barrett Bowling1,2, Richard Sloane3, Carl Pieper3, Alison Luciano3, Barry R Davis4, Lara M Simpson4, Paula T Einhorn5, Suzanne Oparil2, Paul Muntner6. 1. Durham Veterans Affairs Geriatric Research Education and Clinical Center, Durham Veterans Affairs Medical Center (VAMC). 2. Department of Medicine. 3. Center for Study of Aging and Human Development, Duke University, Durham, North Carolina. 4. The University of Texas School of Public Health, Houston, Texas. 5. Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute of the National Institutes of Health, Bethesda, Maryland. 6. Department of Epidemiology, University of Alabama at Birmingham, Birmingham, Alabama, USA.
Abstract
OBJECTIVES: Sustaining SBP control reduces the risk for cardiovascular events that impair function but its association with nursing home admission has not been well studied. METHODS: We conducted an analysis of sustained SBP control and long-term nursing home admissions using data from the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT) linked to Medicare claims restricted to participants with fee-for-service coverage, at least eight study visits with SBP measurements, who were not living in a nursing home during a 48-month baseline BP assessment period (n = 6557). Sustained SBP control was defined as less than 140 mmHg at less than 50%, 50% to less than 75%, 75% to less than 100%, and 100% of visits. Nursing home admissions were identified using the Medicare Long Term Care Minimum Data Set. RESULTS: The mean age of participants was 73.8 years and 44.3% were men. Over a median follow-up of 9.2 years, 844 participants (12.8%) had a nursing home admission. Rates of nursing home admission per 100 person-years were 16.3 for participants with SBP control at less than 50%, 14.1 at 50% to less than 75%, 7.8 at 75% to less than 100%, and 5.3 at 100% of visits. Compared with those with sustained SBP control at less than 50% of visits, hazard ratios (95% confidence intervals) for nursing home admission were 0.79 (0.66-0.93), 0.70 (0.58-0.84), and 0.57 (0.44-0.74) among participants with SBP control at 50% to less than 75%, 75% to less than 100%, and 100% of visits, respectively. CONCLUSION: Among Medicare beneficiaries in ALLHAT, sustained SBP control was associated with a lower risk of long-term nursing home admission.
OBJECTIVES: Sustaining SBP control reduces the risk for cardiovascular events that impair function but its association with nursing home admission has not been well studied. METHODS: We conducted an analysis of sustained SBP control and long-term nursing home admissions using data from the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT) linked to Medicare claims restricted to participants with fee-for-service coverage, at least eight study visits with SBP measurements, who were not living in a nursing home during a 48-month baseline BP assessment period (n = 6557). Sustained SBP control was defined as less than 140 mmHg at less than 50%, 50% to less than 75%, 75% to less than 100%, and 100% of visits. Nursing home admissions were identified using the Medicare Long Term Care Minimum Data Set. RESULTS: The mean age of participants was 73.8 years and 44.3% were men. Over a median follow-up of 9.2 years, 844 participants (12.8%) had a nursing home admission. Rates of nursing home admission per 100 person-years were 16.3 for participants with SBP control at less than 50%, 14.1 at 50% to less than 75%, 7.8 at 75% to less than 100%, and 5.3 at 100% of visits. Compared with those with sustained SBP control at less than 50% of visits, hazard ratios (95% confidence intervals) for nursing home admission were 0.79 (0.66-0.93), 0.70 (0.58-0.84), and 0.57 (0.44-0.74) among participants with SBP control at 50% to less than 75%, 75% to less than 100%, and 100% of visits, respectively. CONCLUSION: Among Medicare beneficiaries in ALLHAT, sustained SBP control was associated with a lower risk of long-term nursing home admission.
Authors: Kevin A Brown; Aaron Jones; Nick Daneman; Adrienne K Chan; Kevin L Schwartz; Gary E Garber; Andrew P Costa; Nathan M Stall Journal: JAMA Intern Med Date: 2021-02-01 Impact factor: 21.873
Authors: Robert E Burke; Emily A Whitfield; David Hittle; Sung-joon Min; Cari Levy; Allan V Prochazka; Eric A Coleman; Robert Schwartz; Adit A Ginde Journal: J Am Med Dir Assoc Date: 2015-12-20 Impact factor: 4.669
Authors: C Barrett Bowling; Barry R Davis; Alison Luciano; Lara M Simpson; Richard Sloane; Carl F Pieper; Paula T Einhorn; Suzanne Oparil; Paul Muntner Journal: J Clin Hypertens (Greenwich) Date: 2019-03-13 Impact factor: 3.738
Authors: C Barrett Bowling; Richard Sloane; Carl Pieper; Alison Luciano; Barry R Davis; Lara M Simpson; Paula T Einhorn; Suzanne Oparil; Paul Muntner Journal: J Gen Intern Med Date: 2021-02-09 Impact factor: 6.473