What question did this study set out to answer?

Assess the effects and safety of deprescribing antihypertensive medications in older adults, especially those with multiple health conditions.

January 10, 2026BMC Geriatrics2 citationsOpen Access

Deprescribing antihypertensive medications in older people: a systematic review and a meta-analysis

CFCarmen Floriani GMGiovanni Minchio ASAngela Edith Schulthess-Lisibach

Key Result

Deprescribing antihypertensive medications in older adults is poorly defined, requiring individualized decision-making due to low-event-rate evidence.

Key Points

Assess the effects and safety of deprescribing antihypertensive medications in older adults, especially those with multiple health conditions.
Conducted a systematic review of existing studies on deprescribing antihypertensive medications.
Performed a meta-analysis to quantify cardiovascular outcomes.
Focused on older adults with frailty and multimorbidity.
Found limited evidence on the effects of deprescribing on cardiovascular events.
Highlighted the need for individualized decision-making in treatment plans.
Identified gaps in research for future exploration.

Structured PICO

Does deprescribing antihypertensive medications reduce all-cause mortality in adults aged 65 years and older?

Population

Adults aged 65 years and older treated with antihypertensive medications (17 studies included: 7 RCTs and 10 comparative observational studies).

Intervention

Deprescribing of antihypertensive drugs, defined as the abrupt discontinuation, withdrawal, or dose reduction of diuretics, beta-blockers, ACE inhibitors, calcium channel blockers, ARBs, or RAAS inhibitors.

Comparator

Continuation of antihypertensive medications.

Outcome

All-cause mortalityhard clinical

Deprescribing antihypertensive medications in older adults has an uncertain effect on all-cause mortality but may increase the risk of heart failure, emphasizing the need for individualized decision-making.

Main Result

Absolute Event Rate: 0% vs 0%

Abstract

The effects of deprescribing antihypertensive medications in older adults remain uncertain. The limited and low-event-rate evidence on key cardiovascular outcomes for older individuals highlights the need for individualized decision-making, especially in frail and multimorbid populations. This review provides a foundation for future research to address gaps and guide safer deprescribing practices in older adults in routine clinical practice.

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