Table 2.

Main barriers and enablers to start, intensify, continue or deprescribe antihypertensive medication

Enabler	Barrier
Starting AHM
High SBP (> 180  mm Hg)	Age > 80  years
History of CVD/DM	Limited life expectancy
Planned operation	Frailty
Patient preference	Psychological impact of starting medication
	Patient preference
Intensifying AHM
High SBP (>140 or >160  mm Hg)	Age> 80  years
Age <80 years	≥3 antihypertensive drugs
History of CVD/DM	Patient preference
	Frailty
Continuing AHM
Automated prescription routines
Time constraints
Requires less justification than deprescribing/intensifying
Anticipating discomfort when disturbing the precarious balance
Target BP level not yet reached
Deprescribing AHM
Prolonged achievement of target BP	Anticipated regret
Side effects, orthostatic hypotension	Deprescribing may give the impression of giving up on a patient
Risk of falling	AHM gives patients a sense of control
Patient preference
Experience with increase in quality of life
Terminal illness

AHM, antihypertensive medication; BP, blood pressure; CVD, cardiovascular disease; DM, diabetes mellitus; SBP, systolic blood pressure.