# Impact of Intensive Blood Pressure Treatment on Clinical Outcomes of Hospitalized Older Adults

> **NIH NIH R03** · BETH ISRAEL DEACONESS MEDICAL CENTER · 2020 · $127,774

## Abstract

PROJECT SUMMARY/ABSTRACT
Older adults accounted for over 12 million hospitalizations in 2015. During hospitalization, blood pressure (BP)
may fluctuate as a result of acute illness, stress, and new medication exposures. Though the long-term
benefits of strict BP control on older adults’ cardiovascular risk are well established, no research has shown a
short-term benefit to treating asymptomatic elevated BPs during hospitalization. Despite this evidence gap,
single-center studies indicate older adults commonly receive intensive BP treatments during hospitalization for
non-cardiac conditions. Older adults are at increased risk of medication-related adverse events while being
treated for and recovering from acute illness, therefore, understanding the benefits and harms of intensively
treating elevated BPs during hospitalization is critically important. While hospitalized for conditions unrelated to
hypertension, older adults may be particularly susceptible to harms resulting from BP overtreatment, including
symptomatic orthostasis, falls, and acute kidney injury. To date, prior studies have not assessed the effect of
intensive inpatient BP treatment on clinical outcomes during hospitalization. The importance of addressing the
knowledge gaps surrounding inpatient BP management is highlighted by prior research on inpatient blood
glucose management which demonstrated that applying outpatient blood glucose treatment targets to the
hospital setting results in increased risks of in-hospital hypoglycemia and mortality. The objective of this
application is to characterize the epidemiology and outcomes of intensively treating elevated BPs in older
adults during hospitalization. We propose a retrospective cohort study of all older adults hospitalized for non-
cardiac conditions in the national Veteran’s Affairs Health System between 2013 and 2015. First, we will
describe how often elevated inpatient BPs are treated intensively among hospitalized older adults and evaluate
patient characteristics associated with intensive BP management. We will use log binominal or Poisson
regression to obtain direct estimates of relative risks of intensive BP treatment by key patient characteristics
including prior outpatient BP control, polypharmacy, multi-morbidity, dementia, and limited life expectancy.
Second, we will evaluate the impact of intensive inpatient BP treatment on in-hospital clinical outcomes
including potential harms (e.g. falls, acute kidney injury) and potential benefits (reduction in acute CV events).
We will compare in-hospital outcomes of older adults who did and did not receive intensive BP treatment using
propensity score matching to control for confounding by indication. We will conduct pre-specified subgroup
analyses to determine whether patients with multi-morbidity, dementia, or limited life expectancy have
increased risk of in-hospital harms. This study will fill a vital knowledge gap and provide key guidance to inform
inpatient BP treatment decis...

## Key facts

- **NIH application ID:** 9993205
- **Project number:** 5R03AG064373-02
- **Recipient organization:** BETH ISRAEL DEACONESS MEDICAL CENTER
- **Principal Investigator:** Timothy S Anderson
- **Activity code:** R03 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $127,774
- **Award type:** 5
- **Project period:** 2019-08-15 → 2023-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9993205

## Citation

> US National Institutes of Health, RePORTER application 9993205, Impact of Intensive Blood Pressure Treatment on Clinical Outcomes of Hospitalized Older Adults (5R03AG064373-02). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/9993205. Licensed CC0.

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