Hypertension is the number one co-morbid condition in older people with multiple chronic conditions, and over half of those aged >80 years are prescribed two or more antihypertensive medications (equivalent to approximately 1.25 million people in the UK). Blood pressure lowering has been shown to be effective at preventing stroke and cardiovascular disease in healthy individuals aged >80 years with systolic blood pressure of >160mmHg. However, more recent evidence suggests that larger blood pressure reductions and multiple antihypertensive prescriptions may be harmful in older people. Whilst reducing the number of antihypertensive drugs prescribed to certain older patients may be beneficial, the lack of evidence to support such an approach limits the practice in routine clinical care.