Deprescribing of hypotensive therapy in hypertensive patients over 60 years (results of the program “GRANAT”)

Objective. To conduct a comprehensive study of comorbidity, medications and to assess the possibilities of deprescribing in hypertensive patients older than 60 years.

Design and methods. The study was registered as an observational program “Arterial hypertension: the main clinical and pharmacological determinants in patients over 60 years” and was conducted within the period from June to August 2018. In total, 460 patients (201/43,7 % — men, the age — 76,72 ± 8,1 years) with hypertension (HTN) were included sequentially.

Results. The main complaints were: headaches (n = 393/85,4 %), decreased memory, attention (305/66,3 %), dizziness (286/62,2 %), back pain (215/46,7 %), joint pain (206/44,8 %), sleep disorders (183/39,8 %), heartburn (179/38,9 %), epigastric pain (154/33,5 %), constipation (147/31,9 %). The main diagnosed pathologies included: ischemic heart disease (332/72,2 %), chronic brain ischemia/dyscirculatory encephalopathy (305/66,3 %), spinal osteoarthrosis (293/63,7 %), chronic gastritis (198/43 %), varicose veins of the lower limbs (136/29,6 %), diabetes mellitus (121/26,3 %), cataract (96/20,9 %). The following medications were taken by the patients: antihypoxants/nootropics/neuroprotectors (302/65,7 %), diuretics (251/54,6 %), angiotensinconverting enzyme (ACE) inhibitors (273/59,4 %), β -blockers (203/44,1 %), non-steroidal anti-inflammatory drugs (NSAIDs) (179/38,9 %), sartans (147/32 %), calcium antagonists (120/26,1 %), proton pump inhibitors (117/25,4 %), statins (111/24,1 %). Among patients, 176 (38,3 %) subjects stopped taking the antihypertensive drugs on their own, they were not informed by the doctor about the possibilities of reducing the dose of antihypertensive drugs and deprescribing technology.

Conclusions. Our data demonstrate the multimorbidity of the population of hypertensive patients over 60 years of age, receiving a wide range of drugs and the need for a comprehensive discussion of the deprescribing approach.

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