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Inclusion

  • Participant is willing and able to give informed consent for participation in the trial.
  • Male or Female, aged 80 years or above.
  • Clinic systolic blood pressure less than 150 mmHg (according to screening measurement at baseline).
  • Prescribed two or more antihypertensive medications to lower blood pressure for at least 12 months prior to trial entry (defined as any ACE inhibitor, angiotensin II receptor blocker, calcium channel blocker, thiazide and thiazide-like diuretic, potassium-sparing diuretic, alpha-blocker or beta-blocker).
  • Stable dose of current antihypertensive medications for at least four weeks prior to trial entry.
  • In the Investigator’s opinion, could potentially benefit from medication reduction due to existing polypharmacy, co-morbidity, non-adherence or dislike of medicines and/or frailty.
  • In the Investigator’s opinion, is able and willing to comply with all trial requirements. 

 exclusion

  • A participant has heart failure due to left ventricular systolic dysfunction (LVSD) and is on only ACE inhibitors/ARBs and/or beta-blockers and/or spironolactone (removing any of which would be contraindicated).
  • A participant has heart failure but has not had an echocardiogram since its onset (might have undiagnosed LVSD and a compelling need for ACEI/ARB and Betablockers).
  • Investigator deems that there is a compelling indication for medication continuation.
  • Suffered a myocardial infarction or stroke within the past 12 months.
  • Blood pressure being managed outside of primary care.
  • A participant with secondary hypertension.
  • A participant with previous accelerated or malignant hypertension.
  • Unable to provide consent due to incapacity.
  • Any other significant disease or disorder which, in the opinion of the Investigator, may either put the participants at risk because of participation in the trial, or may influence the result of the trial, or the participant’s ability to participate in the trial (e.g. terminal illness, house bound and unable to attend baseline and follow up clinics).
  • Participants who have participated in another research trial involving antihypertensive medication in the past 4 weeks.

 

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