{"doi":"10.1001/jamanetworkopen.2024.46851","title":"Antihypertensive Deprescribing and Cardiovascular Events Among Long-Term Care Residents","abstract":"Importance: The practice of deprescribing antihypertensive medications is common among long-term care residents, yet the effect on cardiovascular outcomes is unclear. Objective: To compare the incidence of hospitalization for myocardial infarction (MI) or stroke among long-term care residents who are deprescribed or continue antihypertensive therapy. Design, Setting, and Participants: This comparative effectiveness research study used target trial emulation with observational electronic health record data from long-term care residents aged 65 years or older admitted to US Department of Veterans Affairs community living centers between October 1, 2006, and September 30, 2019, and taking at least 1 antihypertensive medication. Analyses were conducted between August 2023 and August 2024. Exposure: A reduction in the number of antihypertensive medications or dose (by ≥30%), assessed using barcode medication administration data. Main Outcome and Measures: Incidence of MI and stroke hospitalization up to 2 years was assessed using International Classification of Diseases, Ninth Revision and International Statistical Classification of Diseases and Related Health Problems, Tenth Revision codes. A pooled logistic regression model with inverse probability of treatment weighting (IPTW) and inverse probability of censoring weighting (IPCW) was used to estimate per-protocol effects. Results: Of 13 096 long-term care residents (97.4% men; median age, 77 years [IQR, 70-84 years]) taking antihypertensive medication, 17.8% were deprescribed antihypertensive medication over a period of 12 weeks. The estimated unadjusted cumulative incidence of stroke or MI hospitalization over 2 years was similar among residents who were and were not deprescribed antihypertensives in per-protocol analyses (11.2% vs 8.8%; difference, 2.4 percentage points [95% CI, -2.3 to 7.1 percentage points]). Participant characteristics were balanced after applying IPTW and IPCW; all standardized mean differences were less than 0.05. After full adjustment for confounding and informative censoring, the per-protocol analysis results showed no association of antihypertensive deprescribing with MI or stroke hospitalization (hazard ratio, 0.93; 95% CI, 0.70-1.26). Conclusions and Relevance: In this comparative effectiveness research study, deprescribing antihypertensive medication was not associated with risk of hospitalization for MI or stroke in long-term care residents. These findings may be informative for long-term care residents and clinicians who are considering deprescribing antihypertensive medications.","journal":"JAMA Network Open","year":2024,"id":439347,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":10,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9609,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2024-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":557638,"name":"Laura A. Graham","orcid":"0000-0002-7327-3793","position":1,"is_corresponding":false},{"id":970453,"name":"Xiaojuan Liu","orcid":"0000-0002-6429-5982","position":2,"is_corresponding":false},{"id":1231363,"name":"Chintan V. Dave","orcid":"0000-0002-7160-9345","position":3,"is_corresponding":false},{"id":444329,"name":"Sei J. Lee","orcid":"0000-0001-7864-5341","position":4,"is_corresponding":false},{"id":1072959,"name":"Yongmei Li","orcid":"0000-0001-5558-9738","position":5,"is_corresponding":false},{"id":767128,"name":"Bocheng Jing","orcid":"0000-0002-2021-5055","position":6,"is_corresponding":false},{"id":767661,"name":"Kathy Fung","orcid":null,"position":7,"is_corresponding":false},{"id":336202,"name":"Carmen A. Peralta","orcid":"0000-0003-4265-2392","position":8,"is_corresponding":false},{"id":523942,"name":"Michael A. Steinman","orcid":"0000-0002-9564-9480","position":9,"is_corresponding":false},{"id":305264,"name":"Michelle C. Odden","orcid":"0000-0002-5974-3648","position":0,"is_corresponding":true}],"reference_count":28,"raw_metadata":null,"created_at":"2026-07-19T02:00:47.992543Z","pmid":"39585693","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}