NATIONAL TRENDS IN ANTIHYPERTENSIVE PRESCRIBING IN OUTPATIENTS WITH DEMENTIA IN THE UNITED STATES

This study aims to investigate national trends in outpatient antihypertensive prescribing in people with dementia in the United States between 2006 and 2012, and to determine clinical and demographic factors associated with different prescribing patterns. Outpatient visits by people aged ≥65 years with documented dementia were analyzed in the National Ambulatory Medical Care Survey (NAMCS) and the outpatient department component of the National Hospital Ambulatory Medical Care Survey (NHAMCS). Complex samples multivariate logistic regression was conducted to estimate temporal trends and adjusted odds ratios (AORs) with 95% confidence intervals (CIs) for factors associated with prescribing of antihypertensives, multiple antihypertensives and different antihypertensive classes. There was a statistically significant increase in the proportion of physician visits by older people with dementia with a documented diagnosis of hypertension from 49.3% (95%CI: 41.3%–57.4%) in 2006 to 55.7% (95%CI: 50.2%–61.2%) in 2012. There were non-significant increases in overall antihypertensive use and the use of multiple antihypertensive classes. Male sex was associated with a higher prescribing of any antihypertensive (AOR 1.37, 95%CI 1.02–1.84) and multiple antihypertensive medications (AOR 1.52, 95%CI 1.14–2.04). Black race (AOR 2.04, 95%CI 1.12–3.71) and Midwest residence (AOR 2.03, 95%CI 1.46–2.82) were associated with a higher prescribing of multiple antihypertensive medications. In conclusion, there was an increase in documented hypertension in physician visits by older people with dementia from 2006 to 2012, but minimal increases in overall antihypertensive use. Various demographic and clinical factors were associated with the prescribing of antihypertensives in people with dementia.