• Rahimi K, Bidel Z, Nazarzadeh M, et al. Age-stratified and blood-pressure-stratified effects of blood-pressure-lowering pharmacotherapy for the prevention of cardiovascular disease and death: an individual participant-level data meta-analysis. Lancet 2021;398(10305):1053–64. https://doi.org/10.1016/S0140-6736(21)01921-8 . [published Online First: 2021 Aug 27]. Comprehensive analysis of individual patients data from ranodmised controlled trials of blood pressure lowering, showing how the benefits of treatment change with increasing age.
NHS Digital. Health Survey for England 2016: prescribed medicines. http://www.digital.nhs.uk. Health and Social Care Information Centre, 2017.
Sheppard JP, Singh S, Fletcher K, et al. Impact of age and sex on primary preventive treatment for cardiovascular disease in the West Midlands, UK: cross sectional study. BMJ. 2012;345:e4535. https://doi.org/10.1136/bmj.e4535. [publishedOnlineFirst:2012/07/14].
Article CAS PubMed PubMed Central Google Scholar
Mensah GA, Wei GS, Sorlie PD, et al. Decline in cardiovascular mortality: possible causes and implications. Circ Res. 2017;120(2):366–80. https://doi.org/10.1161/circresaha.116.309115. [publishedOnlineFirst:2017/01/21].
Article CAS PubMed PubMed Central Google Scholar
Albasri A, Hattle M, Koshiaris C, et al. Association between antihypertensive treatment and adverse events: systematic review and meta-analysis. BMJ (Clinical research ed). 2021;372: n189. https://doi.org/10.1136/bmj.n189.
• Sheppard JP, Koshiaris C, Stevens R, et al. The association between antihypertensive treatment and serious adverse events by age and frailty: A cohort study. PLoS Med. 2023;20(4):e1004223. https://doi.org/10.1371/journal.pmed.100422. [publishedOnlineFirst:2023/04/19]. Largest study of adverse events associated with antihypertensive treatment, showing a low risk in most patients that increases with advancing age and frailty.
Mangoni AA, Jackson SH. Age-related changes in pharmacokinetics and pharmacodynamics: basic principles and practical applications. Br J Clin Pharmacol. 2004;57(1):6–14. https://doi.org/10.1046/j.1365-2125.2003.02007.x. [publishedOnlineFirst:2003/12/18].
Article CAS PubMed PubMed Central Google Scholar
Masnoon N, Shakib S, Kalisch-Ellett L, et al. What is polypharmacy? A systematic review of definitions. BMC Geriatr. 2017;17(1):230. https://doi.org/10.1186/s12877-017-0621-2. [publishedOnlineFirst:2017/10/12].
Article PubMed PubMed Central Google Scholar
Reeve E, Gnjidic D, Long J, et al. A systematic review of the emerging definition of ‘deprescribing’ with network analysis: implications for future research and clinical practice. Br J Clin Pharmacol. 2015;80(6):1254–68. https://doi.org/10.1111/bcp.12732. [publishedOnlineFirst:2016/03/24].
Article PubMed PubMed Central Google Scholar
Kuberska K, Scheibl F, Sinnott C, et al. GPs’ mindlines on deprescribing antihypertensives in older patients with multimorbidity: a qualitative study in English general practice. Br J Gen Pract: J Roy Coll Gen Pract. 2021;71(708):e498–507. https://doi.org/10.3399/bjgp21X714305. [publishedOnlineFirst:2021/05/19].
van Middelaar T, Ivens SD, van Peet PG, et al. Prescribing and deprescribing antihypertensive medication in older people by Dutch general practitioners: a qualitative study. BMJ Open. 2018;8(4):e020871. https://doi.org/10.1136/bmjopen-2017-020871. [publishedOnlineFirst:2018/04/22].
Article PubMed PubMed Central Google Scholar
Maher RL, Hanlon J, Hajjar ER. Clinical consequences of polypharmacy in elderly. Expert Opin Drug Saf. 2014;13(1):57–65. https://doi.org/10.1517/14740338.2013.827660. [publishedOnlineFirst:2013/10/01].
• Mancia G, Kreutz R, Brunström M, et al. ESH Guidelines for the management of arterial hypertension The Task Force for the management of arterial hypertension of the European Society of Hypertension Endorsed by the European Renal Association (ERA) and the International Society of Hypertension (ISH). J Hypertension 2023. https://doi.org/10.1097/hjh.0000000000003480. [published Online First: 2023/06/22]. First international clinical guidelines on the management of hypertension to propose deprescribing of antihypertensive therapy in specific circumstances, where the benefits of continued treatment may become outweighed by the potential harms.
Morehead S. A Guide to Deprescribing Antihypertensives. In: Thompson A, ed. https://www.primaryhealthtas.com.au/. Primary Health Tasmania, 2022.
Whelton PK, Carey RM, Aronow WS, et al. ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: a report of the american college of cardiology/american heart association task force on clinical practice guidelines. Hypertension (Dallas, Tex: 1979) 2018;71(6):e13–e115. https://doi.org/10.1161/hyp.0000000000000065. [published Online First: 2017/11/15].
National Guideline Centre. National institute for health and care excellence. Hypertension in adults: diagnosis and management [NICE guideline 136]. London: Royal College of Physicians (UK) 2019.
Gnjidic D, Johansson M, Meng DM, et al. Achieving sustainable healthcare through deprescribing. Cochrane Database Syst Rev 2022;10(10):Ed000159. https://doi.org/10.1002/14651858.Ed000159. [published Online First: 2022/10/05].
Mao Y, Ge S, Qi S, et al. Benefits and risks of antihypertensive medication in adults with different systolic blood pressure: a meta-analysis from the perspective of the number needed to treat. Front Cardiovasc Med. 2022;9:986502. https://doi.org/10.3389/fcvm.2022.986502. [publishedOnlineFirst:2022/11/08].
Article CAS PubMed PubMed Central Google Scholar
Poudel A, Yates P, Rowett D, et al. Use of preventive medication in patients with limited life expectancy: a systematic review. J Pain Symptom Manage. 2017;53(6):1097-110.e1. https://doi.org/10.1016/j.jpainsymman.2016.12.350. [publishedOnlineFirst:2017/02/14].
Scott J, Jones T, Redaniel MT, et al. Estimating the risk of acute kidney injury associated with use of diuretics and renin angiotensin aldosterone system inhibitors: A population based cohort study using the clinical practice research datalink. BMC Nephrol. 2019;20(1):481. https://doi.org/10.1186/s12882-019-1633-2.
Article CAS PubMed PubMed Central Google Scholar
Mol A, Bui Hoang PTS, Sharmin S, et al. Orthostatic hypotension and falls in older adults: a systematic review and meta-analysis. J Am Med Dir Assoc. 2019;20(5):589-97.e5. https://doi.org/10.1016/j.jamda.2018.11.003. [publishedOnlineFirst:2018/12/26].
Group SR, Wright JT, Jr., Williamson JD, et al. A Randomized Trial of Intensive versus Standard Blood-Pressure Control. [Erratum appears in N Engl J Med 2017;377(25):2506; PMID: 29262284]. N Engl J Med 2015;373(22):2103–16.
Rodenburg EM, Visser LE, Hoorn EJ, et al. Thiazides and the risk of hypokalemia in the general population. J Hypertension 2014;32(10):2092–7; discussion 97. https://doi.org/10.1097/hjh.0000000000000299. [published Online First: 2014/08/12]
Clegg A, Young J, Iliffe S, et al. Frailty in elderly people. Lancet. 2013;381(9868):752–62. https://doi.org/10.1016/s0140-6736(12)62167-9. [publishedOnlineFirst:2013/02/12].
Benetos A, Rossignol P, Cherubini A, et al. Polypharmacy in the aging patient: management of hypertension in octogenarians. JAMA. 2015;314(2):170–80. https://doi.org/10.1001/jama.2015.7517. [publishedOnlineFirst:2015/07/15].
Article CAS PubMed Google Scholar
Benetos A, Petrovic M, Strandberg T. Hypertension management in older and frail older patients. Circ Res. 2019;124(7):1045–60. https://doi.org/10.1161/CIRCRESAHA.118.313236.
Article CAS PubMed Google Scholar
Rockwood K, Song X, MacKnight C, et al. A global clinical measure of fitness and frailty in elderly people. CMAJ: Can Med Assoc J = journal de l'Association medicale canadienne. 2005;173(5):489–95. https://doi.org/10.1503/cmaj.050051. [published Online First: 2005/09/01].
Fried LP, Tangen CM, Walston J, et al. Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci. 2001;56(3):M146–56. https://doi.org/10.1093/gerona/56.3.m146. [publishedOnlineFirst:2001/03/17].
Article CAS PubMed Google Scholar
Searle SD, Mitnitski A, Gahbauer EA, et al. A standard procedure for creating a frailty index. BMC Geriatr. 2008;8:24. https://doi.org/10.1186/1471-2318-8-24. [publishedOnlineFirst:2008/10/02].
Article PubMed PubMed Central Google Scholar
Rockwood K, Theou O. Using the clinical frailty scale in allocating scarce health care resources. Can Geriatr J. 2020;23(3):210–5. https://doi.org/10.5770/cgj.23.463. [publishedOnlineFirst:2020/09/10].
Article PubMed PubMed Central Google Scholar
Rolfson DB, Majumdar SR, Tsuyuki RT, et al. Validity and reliability of the edmonton frail scale. Age Ageing. 2006;35(5):526–9. https://doi.org/10.1093/ageing/afl041.
Article PubMed PubMed Central Google Scholar
Gobbens RJ, van Assen MA, Luijkx KG, et al. The tilburg frailty indicator: psychometric properties. J Am Med Dir Assoc. 2010;11(5):344–55. https://doi.org/10.1016/j.jamda.2009.11.003. [publishedOnlineFirst:2010/06/01].
Clegg A, Bates C, Young J, et al. Development and validation of an electronic frailty index using routine primary care electronic health record data. Age Ageing. 2016;45(3):353–60. https://doi.org/10.1093/ageing/afw039. [publishedOnlineFirst:2016/03/06].
Article PubMed PubMed Central Google Scholar
Veronese N, Cereda E, Stubbs B, et al. Risk of cardiovascular disease morbidity and mortality in frail and pre-frail older adults: results from a meta-analysis and exploratory meta-regression analysis. Ageing Res Rev. 2017;35:63–73. https://doi.org/10.1016/j.arr.2017.01.003. [publishedOnlineFirst:2017/02/02].
Article PubMed PubMed Central Google Scholar
Lane DA, Lip GYH. Use of the CHA2DS2 VASc and HAS-BLED scores to aid decision making for thromboprophylaxis in nonvalvular atrial fibrillation. Circulation. 2012;126(7):860–5. https://doi.org/10.1161/CIRCULATIONAHA.111.060061.
Hippisley-Cox J, Coupland C, Brindle P. Development and validation of QRISK3 risk prediction algorithms to estimate future risk of cardiovascular disease: prospective cohort study. BMJ (Clin Res Ed). 2017;357:j2099. https://doi.org/10.1136/bmj.j2099. [publishedOnlineFirst:2017/05/26].
Conroy RM, Pyorala K, Fitzgerald AP, et al. Estimation of ten-year risk of fatal cardiovascular disease in Europe: the SCORE project. Eur Heart J 2003;24(11):987–1003. [published Online First: 2003/06/06].
• Archer L, Koshiaris C, Lay-Flurrie S, et al. Development and external validation of a risk prediction model for falls in patients with an indication for antihypertensive treatment: retrospective cohort study. BMJ (Clinical research ed). 2022;379: e070918. https://doi.org/10.1136/bmj-2022-070918[publishedOnlineFirst:2022/11/09]. This study describes the devrivation and external validation of a clinical prediction model for serious falls in patients indicated for antihypertensive therapy, which could be used by clinicians to identify patients who might benefit from antihypertensive deprescribing.
Koshiaris C, Archer L, Lay-Flurrie S, et al. Predicting the risk of acute kidney injury in primary care: derivation and validation of STRATIFY-AKI. The British journal of general practice : the journal of the Royal College of General Practitioners. 2023. https://doi.org/10.3399/bjgp.2022.0389. [publishedOnlineFirst:2023/05/03].
Politi MC, Clark MA, Ombao H, et al. Communicating uncertainty can lead to less decision satisfaction: a necessary cost of involving patients in shared decision making? Health expectations : an international journal of public participation in health care and health policy. 2011;14(1):84–91. https://doi.org/10.1111/j.1369-7625.2010.00626.x. [publishedOnlineFirst:2010/09/24].
Politi MC, Han PK, Col NF. Communicating the uncertainty of harms and benefits of medical interventions. Medical decision making : an international journal of the Society for Medical Decision Making. 2007;27(5):681–95. https://doi.org/10.1177/0272989x07307270. [publishedOnlineFirst:2007/09/18].
Ouellet N, Bergeron AS, Gagnon E, et al. Prescribing and deprescribing in very old age: perceptions of very old adults, caregivers and health professionals. Age Ageing 2022;51(11). https://doi.org/10.1093/ageing/afac244. [published Online First: 2022/11/23].
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