[Deprescribing antihypertensive therapy]

Area of Science:

• Geriatrics and Gerontology
• Clinical Pharmacology
• Internal Medicine

Background:

• Increased life expectancy leads to higher rates of comorbidities and polypharmacy (≥ 5 drugs/day), including excessive polypharmacy (> 9 drugs/day).
• Patient populations with polypharmacy are heterogeneous, requiring tailored therapeutic strategies.
• Deprescribing is emerging as a crucial intervention to optimize medication regimens and improve patient outcomes.

Purpose of the Study:

• To explore the role and application of deprescribing as a therapeutic strategy in managing polypharmacy.
• To define suitable therapeutic targets by considering patient heterogeneity (robust, vulnerable, dependent).
• To assess the safety and applicability of deprescribing, particularly in the context of hypertension management.

Main Methods:

• Review of the concept of deprescribing and its implications for patient management.
• Classification of patients into robust, vulnerable, and dependent categories to guide therapeutic decisions.
• Analysis of the application of deprescribing in specific clinical scenarios, such as hypertension and during heat waves.

Main Results:

• Deprescribing is identified as an important therapeutic tool for improving patient outcomes.
• The approach is considered safe for hypertension management, contingent upon regular patient monitoring.
• Deprescribing is particularly relevant for vulnerable, dependent, and institutionalized patients.

Conclusions:

• Deprescribing is a valuable strategy for managing polypharmacy, especially in aging populations with comorbidities.
• Careful consideration of patient heterogeneity and regular monitoring are essential for successful deprescribing.
• Further research is needed as current scientific evidence supporting deprescribing remains at a moderate level.