Key result
Antihypertensive treatment in frail individuals aged 80 years or older requires a paradigm shift prioritizing quality of life and balancing prescribing with deprescribing.
Why the study?
The optimal management of hypertension in individuals aged 80 years or older with frailty remains uncertain due to multiple gaps in evidence.
Does individualized antihypertensive treatment (including deprescribing) improve quality of life in frail individuals aged 80 years or older with hypertension?
Does individualized antihypertensive treatment (including deprescribing) improve quality of life in frail individuals aged 80 years or older with hypertension?
This review emphasizes the need for individualized hypertension management, prioritizing quality of life and considering deprescribing, in frail patients aged 80 years and older.
Prioritizes QoL-focused care with deprescribing in frail patients ≥80; leaves open RCTs to define safe targets.
The optimal management of hypertension in individuals aged 80 years or older with frailty remains uncertain due to multiple gaps in evidence. Complex health issues, polypharmacy, and limited physiological reserve make responding to antihypertensive treatments unpredictable. Patients in this age group may have limited life expectancy, so their quality of life should be prioritized when making treatment decisions. Further research is needed to identify which patients would benefit from more relaxed blood pressure targets and which antihypertensive medications are preferable or should be avoided. A paradigm shift is required in attitudes towards treatment, placing equal emphasis on deprescribing and prescribing when optimizing care. This review discusses the current evidence on managing hypertension in individuals aged 80 years or older with frailty, but further research is essential to address the gaps in knowledge and improve the care of this population.
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Shantsila et al. (2023) conducted a review in Hypertension with frailty. Antihypertensive treatment was evaluated. Antihypertensive treatment in frail individuals aged 80 years or older requires a paradigm shift prioritizing quality of life and balancing prescribing with deprescribing.
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