ANTIHYPERTENSIVE medications can be safely deprescribed in aged care settings, according to a recent study published in the New England Journal of Medicine, which could reduce the number of pills a patient needs to take, and save on costs.

The researchers investigated outcomes from the tapering of antihypertensive medication in over 1,000 people aged 80 and over in aged care facilities in France.

Those included had an average age of 90, a systolic blood pressure below 130mmHg and were taking at least two (an average of 2.5) antihypertensives at the start of the study.

Half the group underwent a gradual reduction in the number of medications they were taking, and the other half received usual care.

Before patients were allocated to a group, a senior consultant reviewed the antihypertensives being used by each patient and determined those that could be discontinued, and those that could not be discontinued owing to medical necessity.

At the end of the study, the tapering group were taking an average of 1.5 antihypertensives, but there was also a decrease in the usual-care group, who were taking an average of two by the end of the study period.

“Although this decrease was less pronounced than in the step-down group…this finding suggests that physicians may routinely reduce treatments as patients become older and have increasing frailty,” they wrote.

There were no differences between the two groups in terms of adverse events, and around 60% of the cohort died during the four-year follow-up, again with no differences in cause of death between the two groups.

While the outcomes showed that reducing the medication did not alter outcomes for better or worse, it failed to replicate a previous study that found improvements in patient outcomes associated with deprescribing antihypertensives.

Read the paper HERE. KB

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