Three blood pressure pills at 86: when is one too many?

Treating high blood pressure in later life works. This episode is about the narrower question that follows: what to do when someone is 80 or older, already sitting well below target on two or more medicines, and getting dizzy on standing or falling. The hosts walk through who fits that picture, what the OPTIMISE trial found when one medicine was removed from 569 adults aged 80 and older, and what the 2025 Cochrane update adds.

They are careful about what the evidence does not show. Removing a medicine here is a de-intensification to reduce burden, not a treatment with proven outcome benefit, and the DANTE trial found that stopping does not improve memory or daily function. The episode also covers which medicine tends to come off first, the four-week review, and why restarting one is a normal result rather than a failed attempt.

Read the full guide: Deprescribing Antihypertensives in Older Adults. To find someone trained in this work, see the MyDeprescriber provider directory.

The hosts on this episode are AI-generated from the written guide.

Educational only, not medical advice. Never stop a medication without your provider. If you are in crisis in the US, call or text 988.