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WHAT ARE THE POSSIBLE BENEFITS AND RISKS OF PARTICIPATING?

Benefits: 

For those in the control group, there will be no clear additional benefits for taking part in the trial. For those in the intervention group who have their medication reduced, there is the possibility that they will be less likely to fall over, or suffer other side effects which could affect their quality of life. We will not know if this is the case until after the trial is finished. 

Risks:

All participants will receive normal routine care from their GP; those in the control arm will be at no further risk by taking part. As medications which lower blood pressure also lower the risk of heart attack and stroke, those in the intervention arm may be at higher risk if their blood pressure was left unchecked. However, follow-up visits with their GP will be booked at 4 weeks following medication reduction (per medication removed) and if blood pressure is seen to rise significantly, the medication will be restored rendering the likelihood of suffering an adverse event very low.

All risks are outlined in the patient information leaflet, as is a description of our data policy in order to reassure participants and provide clarity. 

Trial Team

Oxford Co-Investigators

External Co-investigators

Marney Williams

Patient Representative

Margaret Ogden

Patient Representative

Professor Andy Clegg

Head of Ageing and Stroke Research, University of Leeds

Professor Jonathan Mant 

Professor of Primary Care Research, University of Cambridge

Professor Rupert Payne

Professor of Primary Care and Clinical Pharmacology, University of Exeter

Funded by the NIHR

Related Publications

Sheppard JP, Burt J, Lown M, et al. Effect of Antihypertensive Medication Reduction vs Usual Care on Short-term Blood Pressure Control in Patients With Hypertension Aged 80 Years and Older: The OPTIMISE Randomized Clinical Trial. JAMA. 2020;323(20):2039–2051. doi:10.1001/jama.2020.4871

Jowett Sue, Kodabuckus Shahela, et al. Cost-Effectiveness of Antihypertensive Deprescribing in Primary Care: a Markov Modelling Study Using Data From the OPTiMISE Trial. Hypertension. 2022;79:1122–1131. https://doi.org/10.1161/HYPERTENSIONAHA.121.18726

Sheppard JP, Lown M, Burt J, Ford GA, Hobbs FDR, Little P, Mant J, Payne RA and McManus RJ (2021) Blood Pressure Changes Following Antihypertensive Medication Reduction, by Drug Class and Dose Chosen for Withdrawal: Exploratory Analysis of Data From the OPTiMISE Trial. Front. Pharmacol. 12:619088. doi: 10.3389/fphar.2021.619088

Sheppard, J.P., Benetos, A. & McManus, R.J. Antihypertensive Deprescribing in Older Adults: a Practical Guide. Curr Hypertens Rep 24, 571–580 (2022). https://doi.org/10.1007/s11906-022-01215-3