{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T13:06:04Z","timestamp":1792242364754,"version":"4.4.0"},"reference-count":25,"publisher":"American Medical Association (AMA)","issue":"11","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"\n Importance<\/jats:title>\n The practice of deprescribing antihypertensive medications is common among long-term care residents, yet the effect on cardiovascular outcomes is unclear.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To compare the incidence of hospitalization for myocardial infarction (MI) or stroke among long-term care residents who are deprescribed or continue antihypertensive therapy.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n 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.<\/jats:p>\n <\/jats:sec>\n \n Exposure<\/jats:title>\n A reduction in the number of antihypertensive medications or dose (by \u226530%), assessed using barcode medication administration data.<\/jats:p>\n <\/jats:sec>\n \n Main Outcome and Measures<\/jats:title>\n \n Incidence of MI and stroke hospitalization up to 2 years was assessed using\n International Classification of Diseases, Ninth Revision<\/jats:italic>\n and\n International Statistical Classification of Diseases and Related Health Problems, Tenth Revision<\/jats:italic>\n 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.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Of 13\u202f096 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, \u22122.3 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).<\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n 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.<\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2024.46851","type":"journal-article","created":{"date-parts":[[2024,11,25]],"date-time":"2024-11-25T11:32:41Z","timestamp":1732534361000},"page":"e2446851","source":"Crossref","is-referenced-by-count":13,"title":["Antihypertensive Deprescribing and Cardiovascular Events Among Long-Term Care Residents"],"prefix":"10.1001","volume":"7","author":[{"given":"Michelle C.","family":"Odden","sequence":"first","affiliation":[{"name":"Geriatric Research Education and Clinical Center, VA Palo Alto Health Care System, Palo Alto, California"},{"name":"Department of Epidemiology and Population Health, Stanford University, Stanford, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura A.","family":"Graham","sequence":"additional","affiliation":[{"name":"Health Economics 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