Reducing number of BP meds may be safe in some older adults

A medication reduction strategy is safe among some older adults treated with antihypertensives, according to a study published in the May 26 issue of the Journal of the American Medical Association.

James P. Sheppard, Ph.D., from the University of Oxford in the United Kingdom, and colleagues evaluated whether antihypertensive medication reduction is possible in patients ≥80 years without significant changes in systolic blood pressure (BP) control or adverse events during 12-week follow-up. Patients (48.5 percent women) were randomly assigned to either antihypertensive medication reduction (removal of one drug [intervention], 282) or usual care (control, 287).

At baseline, patients were prescribed a median of two antihypertensive medications. At 12 weeks, 86.4 percent of patients in the intervention group and 87.7 percent of patients in the control group had a systolic BP <150 mm Hg (adjusted relative risk, 0.98; 97.5 percent 1-sided confidence interval, 0.92 to ∞). In two-thirds of patients, medication reduction was sustained at 12 weeks. In the intervention group, the mean change in systolic BP was 3.4 mm Hg higher versus the control group. At least one serious adverse event was reported in 12 participants in the intervention group and seven in the control group (adjusted relative risk, 1.72; 95 percent confidence interval, 0.7 to 4.3).

“The findings suggest antihypertensive medication reduction can be achieved without substantial change in BP control in some older patients with hypertension,” the authors write.

Several authors disclosed financial ties to the pharmaceutical industry.