Table 1.
Baseline characteristics
| Medication reduction group (n=280) | Usual care group (n=284) | |
|---|---|---|
| Age, years | 84·7 (3·3) | 85·0 (3·6) |
| Age >85 years | 130 (46%) | 143 (50%) |
| Sex | ||
| Female | 130 (46%) | 143 (50%) |
| Male | 150 (54%) | 141 (50%) |
| BMI, kg/m2 | 27·2 (4·2) [n=278] | 28·0 (4·3) [n=271] |
| Ethnicity∗ | ||
| White British | 273 (98%) | 270 (95%) |
| Other ethnicity | 7 (3%) | 14 (5%) |
| Undergraduate or postgraduate degree obtained | 44 (16%) | 39 (14%) |
| Current smoker | 3 (1%) | 5 (2%) |
| Alcohol consumption (report drinking alcohol weekly) | 98 (35%) | 108 (38%) |
| Total cholesterol†, mmol/L | 4·6 (1·2) [n=250] | 4·6 (1·2) [n=256] |
| Montreal Cognitive Assessment score‡ | 24·4 (3·6) [n=278] | 24·0 (4·1) [n=279] |
| EQ-5D-5L score§ | 0·8 (0·2) [n=277] | 0·8 (0·2) [n=281] |
| Modified Rankin Scale score >2 (dependent)¶ | 35/267 (13%) | 41/273 (15%) |
| Electronic Frailty Index (eFI) score|| | 0·14 (0·07) | 0·15 (0·07) |
| Fit (eFI 0 to 0·12) | 121 (43%) | 109 (38%) |
| Mild frailty (eFI >0·12 to 0·24) | 130 (46%) | 140 (49%) |
| Moderate frailty (eFI >0·24 to 0·36) | 27 (10%) | 32 (11%) |
| Severe frailty (eFI >0·36) | 2 (<1%) | 3 (1%) |
| Blood pressure | ||
| Systolic blood pressure, mm Hg | 129·4 (13·2) | 130·5 (12·3) |
| Diastolic blood pressure, mm Hg | 68·4 (9·1) | 70·1 (8·4) |
| History of high blood pressure, years | 16·8 (8·9) [n=267] | 16·4 (9·0) [n=273] |
| Standing systolic blood pressure, mm Hg | 128·7 (15·6) [n=262] | 131·8 (16·2) [n=258] |
| Orthostatic hypotension∗∗ | 15/262 (5%) | 10/258 (4%) |
| Medical history†† | ||
| Chronic kidney disease | 83 (30%) | 102 (36%) |
| Cancer | 66 (24%) | 68 (24%) |
| Cardiac disease‡‡ | 60 (21%) | 60 (21%) |
| Diabetes | 48 (17%) | 53 (19%) |
| Atrial fibrillation | 45 (16%) | 45 (16%) |
| Transient ischaemic attack | 27 (10%) | 22 (8%) |
| Stroke | 23 (8%) | 22 (8%) |
| Peripheral vascular disease | 6 (2%) | 9 (3%) |
| Total number of morbidities | 5·7 (2·7) | 6·0 (3·0) |
| Two or more morbidities | 276 (99%) | 279 (98%) |
| Medication prescriptions | ||
| Any antihypertensive | 280 (100%) | 284 (100%) |
| ACE inhibitor | 141 (50%) | 155 (55%) |
| Angiotensin II receptor blocker | 139 (50%) | 128 (45%) |
| Calcium channel blockers | 199 (71%) | 190 (67%) |
| β blockers | 111 (40%) | 113 (40%) |
| Thiazide and related diuretics | 108 (39%) | 110 (39%) |
| Statin | 184 (66%) | 193 (68%) |
| Antiplatelet | 223 (80%) | 232 (82%) |
| Total antihypertensives | 2 (2–3) | 2 (2–3) |
| Total non-cardiovascular medications | 1 (1–2) | 1 (1–2) |
| Total prescribed medications | 4 (3–7) | 4 (3–7) |
Data are mean (SD), n (%), or median (IQR). Where not all patients had available data, data are shown as n/N (%) or mean (SD) [number of patients with available data]. ACE=angiotensin-converting enzyme.
Ethnic group was defined according to participant’s self-reported ethnicity, using Office for National Statistics categories.
Most recently recorded reading from electronic health records.
Score ranges between 0 and 30 with lower scores representing greater impairment. A score of 26 and over is considered to be normal.
The EQ-5D-5L assesses five aspects of health: mobility, self-care, activities, discomfort, and anxiety or depression. EQ-5D-5L index scores were generated using a crosswalk approach which translates the scores for the five EQ-5D-5L items into a single index value. The index value ranges from –0·594 (worse than death) to 1 (full health).
Modified Rankin scale ranges from 0 (no symptoms) to 5 (severe disability).
The Electronic Frailty Index has 36 items and is estimated from electronic health records. The index ranges from 0 (fit) to 1 (frail).
Orthostatic hypotension was defined as a decrease in systolic blood pressure of ≥20 mm Hg within 3 min of standing.
Individual conditions listed represent the eight most common conditions that are thought to be associated with high blood pressure.
Cardiac disease was defined as the presence of myocardial infarction, coronary heart disease, angina, or heart failure.