Pragmatic Trials Collaborative

Measuring What Matters

Trials In Progress

Blood pressure (BP) normally falls in the last 10 years of life. As a result, long-term care (nursing home) residents who have used BP lowering medication for many years can often end up with a BP that is now lower than necessary. It is commonly believed, but not proven, that this lower than necessary BP may be harmful to frail older adults. OptimizeBP identifies non-opted out antihypertensive-using residents with a systolic BP < 130 mmHg in participating long-term care facilities, and randomizes them to either continue their current doses of BP-lowering medication, or to reduce those medication doses in order to obtain a systolic BP of 140 +/- 5 mmHg. By following mortality, and other health outcomes, we will learn whether or not lower blood pressures are harmful in this frail, end-of life population.

Principal Investigator

Roni Kraut

Trial Details

Trial Registration


OptimizeBP randomized its first patient in a pilot long-term care facility in fall 2021. Other Long-term care facilities are currently being recruited, and additional funding is being sought. Assuming a smooth transition into the full trial, mature data for final analysis is likely sometime in 2025.