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Prevalence of Beta Blocker Prescribing for Hypertension
Brandon J Skory1, John Arko1, Laila Terkawi1
1College of Pharmacy, Northeast Ohio Medical University, Rootstown, OH, USA.
Summary
Beta blockers are frequently prescribed inappropriately for hypertension in the US. This study found over 93% of beta blocker prescriptions lacked compelling indications, especially in older adults.
Area of Science:
- Cardiology
- Pharmacology
- Public Health
Background:
- Beta blockers are not recommended as first-line treatment for hypertension (HTN) unless specific compelling indications exist.
- Despite guidelines, evidence suggests beta blockers are often inappropriately prescribed to US adults with HTN.
Purpose of the Study:
- To determine the rate of beta blocker prescribing for hypertension without concurrent use of other first-line antihypertensive agents.
- To identify factors associated with inappropriate beta blocker prescribing in hypertension management.
Main Methods:
- Analysis of National Ambulatory Medical Care Survey data from 2013-2018 (excluding 2017).
- Inclusion of office visits for adult patients receiving hypertension treatment.
- Study encompassed 5191 unweighted visits, representing 247 million nationally.
Main Results:
- Beta blockers were prescribed in 21.8% of analyzed visits.
- 93.6% of beta blocker prescriptions were deemed inappropriate based on guideline recommendations.
- Older age (≥65) and elevated blood pressure increased likelihood of beta blocker prescription.
Conclusions:
- Inappropriate beta blocker prescribing for hypertension without compelling indications is highly prevalent in US outpatient settings.
- Older adults and patients with elevated blood pressure are at higher risk for inappropriate prescribing.
- Provider education and clinical decision support are needed to improve hypertension management.
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