When cardiovascular medicines should be discontinued

Area of Science:

• Cardiology
• Pharmacology
• Geriatrics

Background:

• Medication initiation is prioritized over discontinuation in clinical practice.
• Long-term medication use, especially in aging patients with evolving conditions, lacks sufficient evidence and guidance for cessation.
• Current clinical practice guidelines offer minimal advice on deprescribing cardiovascular medications.

Purpose of the Study:

• To highlight the need for evidence-based strategies for cardiovascular medication discontinuation.
• To identify cardiovascular medications that may warrant deprescribing.
• To address the potential harms associated with continued, unproven medication use.

Main Methods:

• Review of existing clinical practice guidelines and trial evidence related to cardiovascular medications.
• Discussion and expert opinion on specific cardiovascular medications or classes for potential discontinuation.
• Analysis of risks associated with long-term medication use, including adverse effects, drug interactions, and polypharmacy.

Main Results:

• Significant gap in data and guidelines regarding the deprescribing of cardiovascular medications.
• Potential harms of continuing medications without proven benefit, including drug-drug interactions and polypharmacy.
• Identification of specific cardiovascular medications that should be considered for discontinuation.

Conclusions:

• Deprescribing cardiovascular medications is essential for patient safety and healthcare efficiency.
• Clinicians and patients should consider deprescribing to avoid potential harm and reduce polypharmacy.
• Further research is needed to establish clear guidelines for cardiovascular medication discontinuation.