What are the considerations for people with frailty or multimorbidity when starting antihypertensive drug treatment?
When starting antihypertensive drug treatment, clinical judgement should be used for people of any age with frailty or multimorbidity (see also NICE's guideline on multimorbidity). Healthcare professionals should discuss with the person their individual cardiovascular disease risk and their preferences for treatment, including no treatment, and explain the risks and benefits before starting the treatment. Furthermore, they should consider antihypertensive drug treatment in addition to lifestyle advice for adults aged under 60 with stage 1 hypertension and an estimated 10-year risk below 10%. For people aged over 80 with stage 1 hypertension, consider antihypertensive drug treatment if their clinic blood pressure is over 150/90 mmHg. Finally, for adults aged under 40 with hypertension, consider seeking specialist evaluation of secondary causes of hypertension and a more detailed assessment of the long-term balance of treatment benefit and risks.