Deprescribing antihypertensive medications in older adults with advanced frailty or limited life expectancy is associated with a small increase in systolic blood pressure (mean difference: 4.90 mm Hg) but no increase in diastolic blood pressure, with no corresponding rise in cardiovascular events.

When older, frail people stop taking blood pressure pills, their blood vessels naturally tighten a little and their heart pumps with slightly more force, raising the top number in their blood pressure reading. This change helps their organs get enough blood flow without causing harm because their bodies have already adjusted to lower pressure and don't need the extra force from drugs. Their bottom number stays the same because their arteries are stiff and don't expand or contract much, so the pressure between heartbeats doesn't change. Their heart and brain don't have more problems because their risk of clots or sudden blockages is already very low due to aging and frailty.