Centrally acting antihypertensives and alpha-blockers in people at risk of falls: therapeutic dilemmas—a clinical review

Abstract

Purpose: To summarise the evidence for deprescribing alpha-blockers and centrally acting antihypertensives in older people at risk of falls and to assist clinicians in deciding how to safely de-prescribe these agents. Findings: Alpha-blockers and centrally acting antihypertensives are no longer recommended for the treatment of hypertension unless all other agents are contraindicated or not tolerated. Multiple tools identify these agents as potentially inappropriate and recommend deprescribing. A number of protocols have been developed to safely guide deprescribing. Message: Safer antihypertensives are available that are associated with less adverse effects. Decision aids such as STOPPFalls can assist de-prescribing.