{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T18:36:00Z","timestamp":1787164560858,"version":"build-2736575974"},"reference-count":28,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"vor","delay-in-days":30,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,6,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>While antihypertensive treatment prevents cardiovascular events, it may also increase risks such as falls in patients with frailty. The Optimising Treatment for Mild Systolic Hypertension in the Elderly (OPTiMISE) trial found that deprescribing one antihypertensive drug did not result in worse short-term blood pressure control and long-term follow-up showed no observed harm, but its generalisability to routine clinical practice remains uncertain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study aimed to calibrate the OPTiMISE effect to a representative primary care population in England.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We calibrated the OPTiMISE treatment effect using inverse probability weighting (IPW) based on trial inclusion likelihood. The trial enrolled 569 adults aged \u226580\u00a0years with controlled blood pressure on \u22652 antihypertensive drugs. A target population was reconstructed from electronic health records of 24 participating practices and extrapolated to all English adults aged \u226580\u00a0years, prescribed \u22652 antihypertensive drugs, using NHS Digital data. The primary outcome was all-cause hospitalisation or death. Weighted Cox models estimated calibrated hazard ratios (HRs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The target population included 798\u2009179 individuals (median age 84\u00a0years [81\u201387], 48% female). Compared with OPTiMISE participants, a higher proportion of individuals in target population were overtly frail (25% vs. 11%). After calibration using IPW, deprescribing was not associated with higher risk of hospitalisation or death [calibrated HR 0.94 (95% CI: 0.73\u20131.22)], similar to the long-term follow-up of OPTiMISE [HR 0.93 (95% CI: 0.76\u20131.12)], although with a slightly wider confidence interval.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Calibrating OPTiMISE findings to a representative primary care population frailer than the original participants suggests that the original trial findings could be translated into a real-world population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ageing\/afag192","type":"journal-article","created":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T11:48:02Z","timestamp":1781092082000},"source":"Crossref","is-referenced-by-count":1,"title":["Effect of antihypertensive medication reduction on short-term blood pressure control in older adults: calibration of OPTiMISE trial results to real-world primary care data"],"prefix":"10.1093","volume":"55","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4132-7769","authenticated-orcid":false,"given":"Antoine","family":"Christiaens","sequence":"first","affiliation":[{"name":"Nuffield Department of Primary Care Health Sciences, University of Oxford , Oxford ,","place":["UK"]},{"name":"Louvain Drug Research Institute\/Clinical Pharmacy and Pharmacoepidemiology Research Group, Universit\u00e9 catholique de Louvain , Brussels ,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ariel","family":"Wang","sequence":"additional","affiliation":[{"name":"Nuffield Department of Primary Care Health Sciences, University of Oxford , Oxford ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David A","family":"McAllister","sequence":"additional","affiliation":[{"name":"School of Health and Wellbeing, University of Glasgow , Glasgow ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard J","family":"McManus","sequence":"additional","affiliation":[{"name":"Brighton and Sussex Medical School, University of Sussex , Brighton ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4461-8756","authenticated-orcid":false,"given":"James P","family":"Sheppard","sequence":"additional","affiliation":[{"name":"Nuffield Department of Primary Care Health Sciences, University of Oxford , Oxford ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,7,1]]},"reference":[{"key":"2026070101233964800_ref1","doi-asserted-by":"publisher","first-page":"530","DOI":"10.1186\/1471-2458-14-530","article-title":"Burden of multimorbidity, socioeconomic status and use of health services across stages of life in urban areas: a cross-sectional 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