{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T19:42:22Z","timestamp":1784662942541,"version":"3.55.0"},"reference-count":31,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2020,9,8]],"date-time":"2020-09-08T00:00:00Z","timestamp":1599523200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000377","name":"Dunhill Medical Trust","doi-asserted-by":"publisher","award":["RTF107\/0117"],"award-info":[{"award-number":["RTF107\/0117"]}],"id":[{"id":"10.13039\/501100000377","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000272","name":"National Institute for Health Research","doi-asserted-by":"publisher","award":["NIHR\u2010RP\u2010R2\u201012\u2010015"],"award-info":[{"award-number":["NIHR\u2010RP\u2010R2\u201012\u2010015"]}],"id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000272","name":"National Institute for Health Research","doi-asserted-by":"publisher","award":["Oxford CLAHRC P2\u2010501"],"award-info":[{"award-number":["Oxford CLAHRC P2\u2010501"]}],"id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000272","name":"National Institute for Health Research","doi-asserted-by":"publisher","award":["SPCR 335"],"award-info":[{"award-number":["SPCR 335"]}],"id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100010269","name":"Wellcome Trust","doi-asserted-by":"publisher","award":["211182\/Z\/18\/Z"],"award-info":[{"award-number":["211182\/Z\/18\/Z"]}],"id":[{"id":"10.13039\/100010269","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["agsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J American Geriatrics Society"],"published-print":{"date-parts":[[2020,11]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND\/OBJECTIVES<\/jats:title>\n                    <jats:p>Randomized controlled trials are used to inform clinical guidelines on the management of hypertension in older adults, but it is unclear to what extent these trials represent the general population attending routine clinical practice. This study aimed to define the proportion and characteristics of patients eligible for hypertension trials conducted in older people.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>DESIGN<\/jats:title>\n                    <jats:p>Cross\u2010sectional study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>SETTING<\/jats:title>\n                    <jats:p>A total of 24 general practices in England.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>PARTICIPANTS<\/jats:title>\n                    <jats:p>Anonymized electronic health record data from all individuals aged 80 and older.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>MEASUREMENTS<\/jats:title>\n                    <jats:p>Descriptive statistics were used to define the proportion and characteristics of patients eligible for two previous medication intensification trials (HYVET, SPRINT) and one medication reduction trial (OPTiMISE). A logistic regression model was constructed to estimate predictors of eligibility for each trial.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Of 15,376 patients identified, 268 (1.7%; 95% confidence interval [CI] = 1.5\u20132.0%), 5,290 (34.4%; 95%CI = 33.7\u201335.2%), and 3,940 (25.6%; 95%CI = 24.9\u201326.3%) were eligible for the HYVET, SPRINT, and OPTiMISE trials, respectively. Between 5.6% and 30.7% of exclusions from each trial were due to eligibility criteria excluding those with high or uncontrolled blood pressure. Frailty (odds ratio [OR] = .44; 95%CI = .36\u2013.54 [OPTiMISE]), cardiovascular polypharmacy (OR = .61; 95%CI = .55\u2013.68 [SPRINT]) and multimorbidity (OR = .72; 95%CI = .64\u2013.82 [SPRINT]) were associated with a lower likelihood of being eligible for one or more of the trials.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION<\/jats:title>\n                    <jats:p>A possible unintended consequence of blood pressure criteria used by trials attempting to answer different primary questions is that for many older patients, no trial evidence exists to inform treatment decisions in routine practice. Caution should be exercised when applying results from existing trials to patients with frailty or multimorbidity.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jgs.16749","type":"journal-article","created":{"date-parts":[[2020,9,28]],"date-time":"2020-09-28T17:51:19Z","timestamp":1601315479000},"page":"2508-2515","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":59,"title":["Generalizability of Blood Pressure Lowering Trials to Older Patients: Cross\u2010Sectional Analysis"],"prefix":"10.1111","volume":"68","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4461-8756","authenticated-orcid":false,"given":"James P.","family":"Sheppard","sequence":"first","affiliation":[{"name":"Nuffield Department of Primary Care Health Sciences University of Oxford  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Lown","sequence":"additional","affiliation":[{"name":"Primary Care Population Sciences and Medical Education Unit, Faculty of Medicine University of Southampton  Southampton UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jenni","family":"Burt","sequence":"additional","affiliation":[{"name":"The Healthcare Improvement Studies Institute, University of Cambridge  Cambridge UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eleanor","family":"Temple","sequence":"additional","affiliation":[{"name":"Nuffield Department of Primary Care Health Sciences University of Oxford  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca","family":"Lowe","sequence":"additional","affiliation":[{"name":"Nuffield Department of Primary Care Health Sciences University of Oxford  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hannah","family":"Ashby","sequence":"additional","affiliation":[{"name":"Nuffield Department of Primary Care Health Sciences University of Oxford  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oliver","family":"Todd","sequence":"additional","affiliation":[{"name":"Academic Unit of Elderly Care and Rehabilitation University of Leeds  Leeds UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie","family":"Allen","sequence":"additional","affiliation":[{"name":"Nuffield Department of Primary Care Health Sciences University of Oxford  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gary A.","family":"Ford","sequence":"additional","affiliation":[{"name":"Radcliffe Department of Medicine University of Oxford  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosalyn","family":"Fraser","sequence":"additional","affiliation":[{"name":"Nuffield Department of Primary Care Health Sciences University of Oxford  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carl","family":"Heneghan","sequence":"additional","affiliation":[{"name":"Nuffield Department of Primary Care Health Sciences University of Oxford  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F.D. Richard","family":"Hobbs","sequence":"additional","affiliation":[{"name":"Nuffield Department of Primary Care Health Sciences University of Oxford  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sue","family":"Jowett","sequence":"additional","affiliation":[{"name":"Institute of Applied Health Research, University of Birmingham  Birmingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Little","sequence":"additional","affiliation":[{"name":"Primary Care Population Sciences and Medical Education Unit, Faculty of Medicine University of Southampton  Southampton UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan","family":"Mant","sequence":"additional","affiliation":[{"name":"Primary Care Unit, Department of Public Health and Primary Care University of Cambridge  Cambridge UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jill","family":"Mollison","sequence":"additional","affiliation":[{"name":"Nuffield Department of Primary Care Health Sciences University of Oxford  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rupert","family":"Payne","sequence":"additional","affiliation":[{"name":"Centre for Academic Primary Care University of Bristol  Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marney","family":"Williams","sequence":"additional","affiliation":[{"name":"Patient and Public Involvement Representative  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ly\u2010Mee","family":"Yu","sequence":"additional","affiliation":[{"name":"Nuffield Department of Primary Care Health Sciences University of Oxford  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard J.","family":"McManus","sequence":"additional","affiliation":[{"name":"Nuffield Department of Primary Care Health Sciences University of Oxford  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,9,8]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(02)11911-8"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(15)01225-8"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0801369"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1511939"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/HJH.0b013e328339f9c5"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/HJH.0000000000001787"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2013.14764"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2016-012690"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2014.8012"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/afz072"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.16272"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(04)17670-8"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.14681"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjopharm.2009.08.002"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1093\/gerona\/glv228"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.mad.2006.08.005"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/afs051"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2018-022930"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2318-14-72"},{"key":"e_1_2_6_21_1","first-page":"143","article-title":"Polypharmacy and adverse drug reactions in Japanese elderly taking antihypertensives: a retrospective database study","volume":"5","author":"Sato I","year":"2013","journal-title":"Drug Healthc Patient Saf."},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.b2393"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2017.11.005"},{"key":"e_1_2_6_24_1","volume-title":"Hypertension in Adults: Diagnosis and Management [NICE Guideline 136]","author":"National Guideline Centre","year":"2019"},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehy339"},{"key":"e_1_2_6_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cjca.2018.02.022"},{"key":"e_1_2_6_27_1","unstructured":"Public Health England. National General Practice Profiles.2018.https:\/\/fingertips.phe.org.uk\/profile\/general-practice. Accessed May 21 2019."},{"key":"e_1_2_6_28_1","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.117.10479"},{"key":"e_1_2_6_29_1","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/afw039"},{"key":"e_1_2_6_30_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.2010.02764.x"},{"key":"e_1_2_6_31_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12916-015-0328-1"},{"key":"e_1_2_6_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2015.10.037"}],"container-title":["Journal of the American Geriatrics Society"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jgs.16749","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/jgs.16749","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/agsjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jgs.16749","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,3]],"date-time":"2025-11-03T11:09:54Z","timestamp":1762168194000},"score":1,"resource":{"primary":{"URL":"https:\/\/agsjournals.onlinelibrary.wiley.com\/doi\/10.1111\/jgs.16749"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,9,8]]},"references-count":31,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2020,11]]}},"alternative-id":["10.1111\/jgs.16749"],"URL":"https:\/\/doi.org\/10.1111\/jgs.16749","archive":["Portico"],"relation":{},"ISSN":["0002-8614","1532-5415"],"issn-type":[{"value":"0002-8614","type":"print"},{"value":"1532-5415","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,9,8]]},"assertion":[{"value":"2020-04-06","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-05-11","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-09-08","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}