HypertensionRandomised controlled trial
Reduction of Antihypertensive Treatment in Nursing Home Residents
- Randomised controlled trial
- multicentre
Authors' conclusion
Among older nursing home residents with frailty who were receiving treatment with antihypertensive agents and had a systolic blood pressure below 130 mm Hg, an antihypertensive treatment step-down strategy did not lead to lower all-cause mortality than usual care.
Study context
- Population
- Nursing home residents aged ≥80 years in France receiving >1 antihypertensive drug with SBP <130 mm Hg
- Participants
- 1,048 residents
- Comparison
- Step-down of antihypertensive treatment vs usual care
- Step-downn = 528
- Usual caren = 520reference
- Primary endpoint
- All-cause death
- Follow-up
- Up to 4 years
Primary result
As reported in the abstract
median potential follow-up 38.4 months
Adjusted hazard ratio
1.02
95% CI 0.86–1.21
P = 0.78
Events by treatment group
Step-down vs Usual care
adjusted HR 1.02 (95% CI 0.86–1.21); P = 0.78
Secondary outcomes
| Outcome | adjusted mean difference (mm Hg) (95% CI) | |
|---|---|---|
| Change in SBP during follow-up | 4.1 (1.9–5.7) | |
| −50510Difference, mm Hg (linear scale) |
Number of antihypertensive drugs, baseline to last trial visit
- Step-down: decreased from 2.6±0.7 to 1.5±1.1 (mean ±SD)
- Usual care: decreased from 2.5±0.7 to 2.0±1.1 (mean ±SD)
Safety
Adverse events
- No apparent differences in adverse events between the trial groups
Original publication
Reduction of Antihypertensive Treatment in Nursing Home Residents. N Engl J Med. Published 29 August 2025. doi:10.1056/nejmoa2508157
Summarised from the published abstract; every number is checked against it