Sustained SBP control and long-term nursing home admission among Medicare beneficiaries.
Sustained SBP control and long-term nursing home admission among Medicare beneficiaries.
复制标题
DOI：
10.1097/hjh.0000000000002926
复制
发表时间：
2021-11-01
影响因子：
4.9
通讯作者：
Muntner, Paul
中科院分区：
文献类型：
--
作者：
Bowling, C. Barrett;Sloane, Richard;Pieper, Carl;Luciano, Alison;Davis, Barry R.;Simpson, Lara M.;Einhorn, Paula T.;Oparil, Suzanne;Muntner, Paul
持续控制收缩压（SBP）可降低损害功能的心血管事件的风险，但其与入住疗养院的关系尚未得到充分研究。我们使用来自抗高血压和降脂治疗预防心脏病发作试验（ALLHAT）的数据对持续SBP控制和长期入住疗养院进行了分析，该试验与医疗保险索赔相关，仅限于具有按服务付费覆盖范围的参与者，≥8次研究访视测量SBP，在48个月基线BP评估期间未住在疗养院（n= 6，557）。持续SBP控制定义为<140 mm Hg（<50%、50%至<75%、75%至<100%和100%访视）。疗养院的入院情况是使用医疗保险长期护理最低数据集确定的。参与者的平均年龄为73.8岁，44.3%为男性。在平均9.2年的随访中，844名参与者（12.8%）住进了疗养院。SBP控制在<50%的参与者每100人-年入住疗养院的比率为16.3，50%至<75%的参与者为14.1，75%至<100%的参与者为7.8，100%的参与者为5.3。与持续收缩压控制<50%的患者相比，（95%置信区间）为0.79在SBP控制在50%至<75%、75%至<100%和100%访视的参与者中，分别为（0.66-0.93）、0.70（0.58-0.84）和0.57（0.44-0.74）。在ALLHAT的医疗保险受益人中，持续的SBP控制与长期入住疗养院的风险较低相关。
Sustaining systolic blood pressure (SBP) control reduces the risk for cardiovascular events that impair function, but its association with nursing home admission has not been well studied. 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, ≥8 study visits with SBP measurements, who were not living in a nursing home during a 48-month baseline BP assessment period (n=6,557). Sustained SBP control was defined as <140 mm Hg at <50%, 50% to <75%, 75% to <100%, and 100% of visits. Nursing home admissions were identified using the Medicare Long Term Care Minimum Data Set. 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 <50%, 14.1 at 50% to <75%, 7.8 at 75% to <100%, and 5.3 at 100% of visits. Compared to those with sustained SBP control at <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 <75%, 75% to <100%, and 100% of visits, respectively. Among Medicare beneficiaries in ALLHAT, sustained SBP control was associated with a lower risk of long-term nursing home admission.
影响因子：
6.3
作者：
Bowling CB;Sloane R;Pieper C;Luciano A;Davis BR;Simpson LM;Einhorn PT;Oparil S;Muntner P
通讯作者：
Muntner P