Deprescribing BP medications does not disturb BP control in elderly: JAMA

This noninferiority OPTIMISE trial included 569 participants (mean age, 84.8 years; median of 2 antihypertensive medications prescribed at baseline). They were randomly assigned to receive to a strategy of antihypertensive medication reduction (removal of 1 drug [intervention], n = 282) or usual care (control, n = 287), in which no medication changes were mandated in ratio 1:1.

The primary outcome was systolic blood pressure lower than 150 mm Hg at a 12-week follow-up. 

The researchers found that among older patients treated with multiple antihypertensive medications, a strategy of medication reduction, compared with usual care, was noninferior with regard to systolic blood pressure control at 12 weeks.

"The findings suggest antihypertensive medication reduction in some older patients with hypertension is not associated with a substantial change in blood pressure control, although further research is needed to understand long-term clinical outcomes," the authors concluded.

The study, "Effect of Antihypertensive Medication Reduction vs Usual Care on Short-term Blood Pressure Control in Patients With Hypertension Aged 80 Years and Older: The OPTIMISE Randomized Clinical Trial," is published in the journal JAMA.

DOI: 10.1001/jama.2020.4871