Workshop organised by the FHU CARTAGE-PROFILES on Deprescribing antihypertensive medications in older patients: Indications, risks, benefits and clinical practice - supported by the EuGMS

Workshop organised by the FHU CARTAGE-PROFILES on Deprescribing antihypertensive medications in older patients: Indications, risks, benefits and clinical practice - supported by the EuGMS

On February 2, 2024, The “Federation Hospital –University” on Cardiac and Arterial Ageing Profiles (FHU CARTAGE-PROFILES) held a workshop in Nancy, France, entitled « Deprescribing antihypertensive medications in older patients : Indications, risks, benefits and clinical practice ». This seminar was held under the auspices of the European Geriatric Medicine Society (EuGMS) and the European Society of Hypertension (ESH), and co-organized by the INSERM research unit (U1116) in Nancy. 

 FHU CARTAGE-PROFILES’s objective is to foster multidisciplinary research focusing on chronic age-related cardiovascular and renal diseases in order to promote healthy aging. FHU CARTAGE-PROFILE is headed by Prof. Athanase Benetos, past-president of the EuGMS and current Chair of the ESH working group on Hypertension in Older Adults  

After warm greetings from the President of the University of Lorraine, the Associate General Director of Nancy University Hospital, the Head of Biomedical Research of the University of Lorraine and the Director of Clinical Research Nancy University Hospital, the meeting began with a presentation of the 2023 ESH guidelines on management of hypertension by Prof. Alexandre Persu of Belgium.  This excellent presentation reviewed the scientific basis for treatment of hypertension and the recent changes to the guidelines.  Then, Prof. Benetos presented the specificities of the guidelines concerning older patients, and stressed the heterogeneity of the older population and the importance of incorporating frailty assessment when treating hypertension in these patients.  Assoc. Prof. James Sheppard of Oxford then expertly reviewed the risk/benefit ratio of antihypertensive treatment, pointing out the relative increase in the risks and adverse effects of these medications in older patients.  Next, Prof. Nicolas Girerd of Nancy discussed the potential cardiovascular consequences of reducing antihypertensive medications in older hypertensive patients presenting with heart failure.  Finally, Prof. Richard McManus of Oxford shared the though-provoking long-term results of their deprescription trial (OPTiMISE) and reported on the extension of this study and future developments in the field. 

After a brief lunch break, Prof. Benetos presented the results of the ESH Working Group survey on the management of older adults with hypertension, in 50 ESH Excellence Centers all over Europe that completed this survey.

Finally, a round table moderated by Prof. Laure Joly of Nancy brought together cardiologists, general practitioners and geriatricians to discuss how to promote deprescription in clinical practice and the day-to-day challenges when facing this situation. 

The main conclusion of this workshop was that this important therapeutic area requires:

• Promote education on deprescribing to medical students and physicians
• Improve coordination between physicians from different specialists and clinical pharmacists
• Develop research especially clinical trials including very old and frail patients

The FHU CARTAGE-PROFILES looks forward to contributing further to this effort in order to improve clinical practice especially for the most vulnerable patients.