80 CHAPTER 2.2 Table SI1.1. Continued. STOPP Action Clarity rating Condition Clarity rating Explanation Clarity rating B10 Centrally-acting antihypertensives (e.g. methyldopa, clonidine, moxonidine, rilmenidine, guanfacine), 33% unless clear intolerance of, or lack of efficacy with, other classes of antihypertensives 75% (centrally-active antihypertensives are generally less well tolerated by older people than younger people). 50% B11 ACE inhibitors or Angiotensin Receptor Blockers 67% in patients with hyperkalaemia. 50% N/A B12 Aldosterone antagonists (e.g. spironolactone, eplerenone) with concurrent potassium-conserving drugs (e.g. ACEI’s, ARB’s, amiloride, triamterene) 50% without monitoring of serum potassium 67% (risk of dangerous hyperkalaemia i.e. > 6.0 mmol/l – serum K should be monitored regularly, i.e. at least every 6 months). 92% B13 Phosphodiesterase type-5 inhibitors (e.g. sildenafil, tadalafil, vardenafil) 50% in severe heart failure characterised by hypotension i.e. systolic BP < 90 mmHg, or concurrent nitrate therapy for angina 33% (risk of cardiovascular collapse). 67% C C1 Long-term aspirin at doses greater than 160mg per day 83% 92% (increased risk of bleeding, no evidence for increased efficacy). 75% C2 Aspirin 92% with a past history of peptic ulcer disease without concomitant PPI 100% (risk of recurrent peptic ulcer). 83%
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