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 < 135 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


To date, 18 participating Alberta long-term care facilities have randomized over 400 residents to either a less aggressive blood pressure target, or usual care. An interim analysis is anticipated mid-2024, and a final analysis late-2025.