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Laboratory testing in newly treated elderly hypertensive patients without co-morbidities: a population-based cohort

Finlay Aleck McAlister, Karen Tu, Sumit R Majumdar

    Open Medicine : a Peer-Reviewed, Independent, Open-Access Journal
    |January 27, 2010
    PubMed

    Insights

    Laboratory monitoring for hypertension is infrequent, with newer drug classes showing slightly less testing than thiazides. The differences in testing frequency and cost between these antihypertensive drug classes were minimal in elderly patients.

    Area of Science:

    • Clinical Pharmacy
    • Cardiovascular Research
    • Health Services Research

    Background:

    • The clinical benefit of newer antihypertensive medications often includes reduced laboratory testing, but real-world monitoring practices are not well-documented.
    • Understanding laboratory testing patterns across different antihypertensive drug classes is crucial for optimizing patient care and resource allocation.

    Purpose of the Study:

    • To investigate the frequency and types of laboratory tests conducted in elderly patients initiating monotherapy for uncomplicated hypertension.
    • To compare laboratory monitoring rates between newer antihypertensive drug classes and traditional thiazide diuretics.

    Main Methods:

    • A population-based cohort study utilizing linked administrative databases in Ontario, Canada.
    • Inclusion of elderly residents (66+ years) newly treated with antihypertensive monotherapy between 1994-2002, followed for 24 months.
    • Analysis of laboratory test frequency and type during monotherapy, adjusting for potential confounders.

    Main Results:

    • Out of 164,413 patients, 39% received thiazides and 46% received newer drug classes initially.
    • Baseline laboratory testing was absent in 59% of patients; only 49% underwent testing during monotherapy.
    • Testing was less frequent with newer agents (ACE inhibitors, CCBs, ARBs) compared to thiazides, but absolute differences were small.

    Conclusions:

    • Laboratory monitoring is less frequent with newer antihypertensive drug classes compared to thiazides.
    • Overall laboratory monitoring remains infrequent in elderly hypertensive patients without comorbidities.
    • The observed differences in testing frequency and associated costs between drug classes are clinically minor.
    Abstract

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