TI Best Evidence Webinar
TITLE: Withdrawal of antihypertensive drugs in older people
PRESENTER: Dr. Emily Reeve is a pharmacist and Senior Research Fellow in the Quality Use of Medicines and Pharmacy Research Centre, UniSA Clinical and Health Sciences, at the University of South Australia. Dr Reeve is currently supported by an Australian National Health and Medical Research Council (NHMRC) Investigator Grant. Her research focuses on optimising medication use through deprescribing in older adults and people living with dementia. She has a particular interest in consumer attitudes towards deprescribing and the development of deprescribing guidelines.
This webinar has already taken place. Scroll down to view a video recording of the event.
DATE: Wednesday, March 17th, 2021
TIME: 19:00 – 20:00 Pacific Standard Time PST [UTC -7 convert to your local time]
CME CREDITS: MainPro+/MOC Section 1 credits: 1.0. You must register, attend the webinar and complete the evaluation in order to receive your certificate.
Learning Objectives
- An understanding of the process of conducting a Cochrane systematic review
- Knowledge of the potential benefits and harms of withdrawal of antihypertensives used for hypertension or primary prevention of cardiovascular disease in older adults
- An appreciation of the limitations of evidence as well as considerations for future research in this field
- Knowledge of factors to consider when determining whether deprescribing of antihypertensives is appropriate in older adults
Excellent presentation that underscores the issues facing clinicians: BP targets, preventative medications (e/g statins, ASA),
This presentation kind of underscored the difficulty in deciding what targets are acceptable for the elderly as there are just so many targets (CKD, CM, HTN) and no real guidance in the case of the elderly, so we tend to treat to “tight targets” which may not be appropriate. Would be great to have some “standard” guidelines for the elderly.
How often to monitor BP and with what goal?
Hi Melanie.
Just responding to your note to the Therapeutics Initiative. We addressed the issue of hypertension treatment of the elderly in a newsletter which you can find here:
https://www.ti.ubc.ca/2008/10/31/treatment-of-elevated-blood-pressure-in-the-very-elderly-less-is-better/
Thank you for your comments.
Cheers, Alan Cassels
a few thoughts (bedside to bench/or endpoint collector… (1) geriatrics by necessity is a heterogeneous group, and balancing polymorb + polypharm is often a tightrope, sometimes with dental floss. BP targets, 1,2.3’ary management, and most endpoints aside most in this cohort are overtreated with antiBP agents. (2) frailty must be captured using objective measures, but also there must be a clinical gestalt to inform treatment/management. (3) NNT major CV event vs NNH major traumatic event from OH (head bleed, hip # – this group also dies), much like basic EBM — it all depends. Thanks for archiving this great lecture, originally registered but ended up on call.