Deprescribing Antihypertensive Drugs in Patients of Older Age Groups
Arterial hypertension (AH) is one of the most common diseases in the elderly. It has been proven that lowering blood pressure (BP) is effective in preventing stroke and cardiovascular complications in patients even at the age of ≥80 years. On the other hand, there is evidence that a significant decr...
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| Format: | Article |
| Language: | English |
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Столичная издательская компания
2020-03-01
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| Series: | Рациональная фармакотерапия в кардиологии |
| Subjects: | |
| Online Access: | https://www.rpcardio.online/jour/article/view/2128 |
| _version_ | 1797232119884283904 |
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| author | O. D. Ostroumova M. S. Cherniaeva D. A. Sychev |
| author_facet | O. D. Ostroumova M. S. Cherniaeva D. A. Sychev |
| author_sort | O. D. Ostroumova |
| collection | DOAJ |
| description | Arterial hypertension (AH) is one of the most common diseases in the elderly. It has been proven that lowering blood pressure (BP) is effective in preventing stroke and cardiovascular complications in patients even at the age of ≥80 years. On the other hand, there is evidence that a significant decrease in BP can be harmful to older people and may lead to a higher risk of overall mortality. Therefore, existing guidelines for the treatment of AH determine specific approaches for managing patients of older age groups, where the target BP levels are determined not only by age and concomitant diseases, but also by the presence of frailty. Moreover, there is a need to monitor the dynamics of frailty indicators (social, functional, cognitive and mental status of the patient), since their deterioration may require changes in the tactics of antihypertensive therapy (dose reduction, drug withdrawal or replacement) and changes in target BP levels. In this regard, in recent years, the possibility/necessity of a planned and controlled process of dose reduction, drug withdrawal or replacement, if this drug can be harmful and/or does not bring benefits (deprescribing), has attracted attention. This article is a review of current literature, which presents the design and main characteristics of randomized clinical trials (RCTs) and systematic reviews on the deprescribing of antihypertensive drugs in elderly patients with AH and frailty. An analysis of these studies showed the benefits of deprescribing of antihypertensive drugs for elderly patients with frailty, which avoids potential harm to their health, improves the quality of life and reduces the economic cost of treatment. Therefore, deprescribing of antihypertensive drugs can be used as an additional tool to achieve the necessary target BP values in patients of an older age group. However, for the development of deprescribing of antihypertensive drugs schemes and its introduction into clinical practice, the results of large specially planned RCTs are needed to study this issue. |
| first_indexed | 2024-03-08T14:01:32Z |
| format | Article |
| id | doaj.art-db7a3608595f4a2ea717a411eef79d60 |
| institution | Directory Open Access Journal |
| issn | 1819-6446 2225-3653 |
| language | English |
| last_indexed | 2024-04-24T15:55:13Z |
| publishDate | 2020-03-01 |
| publisher | Столичная издательская компания |
| record_format | Article |
| series | Рациональная фармакотерапия в кардиологии |
| spelling | doaj.art-db7a3608595f4a2ea717a411eef79d602024-04-01T07:43:39ZengСтоличная издательская компанияРациональная фармакотерапия в кардиологии1819-64462225-36532020-03-01161829310.20996/1819-6446-2020-02-141704Deprescribing Antihypertensive Drugs in Patients of Older Age GroupsO. D. Ostroumova0M. S. Cherniaeva1D. A. Sychev2Russian Medical Academy of Continuing Professional Education; I.M. Sechenov First Moscow State Medical University (Sechenov University)Central State Medical Academy, Administrative Directorate of the President of the Russian Federation MarshalaRussian Medical Academy of Continuing Professional EducationArterial hypertension (AH) is one of the most common diseases in the elderly. It has been proven that lowering blood pressure (BP) is effective in preventing stroke and cardiovascular complications in patients even at the age of ≥80 years. On the other hand, there is evidence that a significant decrease in BP can be harmful to older people and may lead to a higher risk of overall mortality. Therefore, existing guidelines for the treatment of AH determine specific approaches for managing patients of older age groups, where the target BP levels are determined not only by age and concomitant diseases, but also by the presence of frailty. Moreover, there is a need to monitor the dynamics of frailty indicators (social, functional, cognitive and mental status of the patient), since their deterioration may require changes in the tactics of antihypertensive therapy (dose reduction, drug withdrawal or replacement) and changes in target BP levels. In this regard, in recent years, the possibility/necessity of a planned and controlled process of dose reduction, drug withdrawal or replacement, if this drug can be harmful and/or does not bring benefits (deprescribing), has attracted attention. This article is a review of current literature, which presents the design and main characteristics of randomized clinical trials (RCTs) and systematic reviews on the deprescribing of antihypertensive drugs in elderly patients with AH and frailty. An analysis of these studies showed the benefits of deprescribing of antihypertensive drugs for elderly patients with frailty, which avoids potential harm to their health, improves the quality of life and reduces the economic cost of treatment. Therefore, deprescribing of antihypertensive drugs can be used as an additional tool to achieve the necessary target BP values in patients of an older age group. However, for the development of deprescribing of antihypertensive drugs schemes and its introduction into clinical practice, the results of large specially planned RCTs are needed to study this issue.https://www.rpcardio.online/jour/article/view/2128arterial hypertensiondeprescribingantihypertensive drugsolder and very old agefrailty |
| spellingShingle | O. D. Ostroumova M. S. Cherniaeva D. A. Sychev Deprescribing Antihypertensive Drugs in Patients of Older Age Groups Рациональная фармакотерапия в кардиологии arterial hypertension deprescribing antihypertensive drugs older and very old age frailty |
| title | Deprescribing Antihypertensive Drugs in Patients of Older Age Groups |
| title_full | Deprescribing Antihypertensive Drugs in Patients of Older Age Groups |
| title_fullStr | Deprescribing Antihypertensive Drugs in Patients of Older Age Groups |
| title_full_unstemmed | Deprescribing Antihypertensive Drugs in Patients of Older Age Groups |
| title_short | Deprescribing Antihypertensive Drugs in Patients of Older Age Groups |
| title_sort | deprescribing antihypertensive drugs in patients of older age groups |
| topic | arterial hypertension deprescribing antihypertensive drugs older and very old age frailty |
| url | https://www.rpcardio.online/jour/article/view/2128 |
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