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Primary care
Deprescribing cardiovascular drugs in low-risk patients increases the risk of uncontrolled blood pressure and LDL-cholesterol
  1. Daniel Caldeira1,2,3
  1. 1 Laboratório de Farmacologia Clínica e Terapêutica, Faculdade de Medicina da Universidade de Lisboa, Lisboa, Portugal
  2. 2 Centro Cardiovascular daUniversidade de Lisboa - CCUL, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
  3. 3 Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
  1. Correspondence to Professor Daniel Caldeira, Laboratório de Farmacologia Clínica e Terapêutica, Faculdade de Medicina da Universidade de Lisboa, Lisboa, 1649-028, Portugal; dgcaldeira{at}hotmail.com

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Commentary on: Luymes CH, Poortvliet RKE, van Geloven N, et al. Deprescribing preventive cardiovascular medication in patients with predicted low cardiovascular disease risk in general practice - the ECSTATIC study: a cluster randomised non-inferiority trial. BMC Med. 2018;16(1):5.

Context

The prescription of cardiovascular drugs in primary prevention may be challenging due to the risk of adverse drug reactions overcoming the benefits in a population with low cardiovascular risk.1 The impact of drug deprescription in this context is still unknown.

Methods

This was a multicentric, open-label, cluster randomised controlled trial comparing the effect of the deprescription of cardiovascular drugs versus usual care.2 The trial included patients aged between 40 and 70 years with a low risk of cardiovascular events treated with antihypertensive drugs or lipid-lowering drugs for more than 1 year. The primary outcome was the difference in …

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