Less is more? Our new trial suggests #deprescribing #bloodpressure lowering medications is safe in the short-term in older people with frailty and multimorbidity – see thread for details https://jamanetwork.com/journals/jama/article-abstract/2766421 #hypertension #RCT @richardjmcmanus @jenniaburt @HomeUrs29 @prof_mant

1/ #Deprescribing of antihypertensive medications is recommended for some older patients with #polypharmacy and #multimorbidity where the benefits of continued treatment ( #stroke risk reduction) may not outweigh the harms (increased risk of #falls #kidneyinjury)

2/ Design: #primarycare based non-inferiority #RCT in patient aged 80 years+ examining whether removal of 1 #antihypertensive is possible without changes in systolic BP control or adverse events over 12 weeks of follow-up

2/ Results: 86% of patients in the #deprescribing group and 88% of patients in the usual care group still had controlled BP. 2/3 of people in the deprescribing group were taking fewer #antihypertensive medications at follow-up

3/ Results: Mean systolic BP was 3.4 mmHg higher in the deprescribing group but there were no differences in QoL, frailty, side effects or serious adverse events #SAEs

4/ Interpretation: #Antihypertensive #deprescribing can be achieved without substantial change in SBP control in 2/3 patients; However, the long term impacts remain unknown so healthcare professionals should continue to use clinical judgement when deciding whether to #deprescribe

5/ Many thanks to the 100s of people that made this trial possible @PCU_Cambridge @oxprimarycare @UoS_PrimaryCare @capcbristol @nihr_tvsm @crnwestengland @CRN_WMid @NIHRCRNEastern @NIHRCRNWessex and all of the amazing GPs and patients who participated

6/ And thanks to our generous funders @arc_oxtv @nihrspcr @wellcometrust @oxfordbrc