How would you approach de-intensifying antihypertensives in frail older adults with SBP < 130 mmHg who have nephrotic range proteinuria, given the results of the RETREAT-FRAIL trial?

How would you approach de-intensifying antihypertensives in frail older adults with SBP < 130 mmHg and nephrotic range proteinuria?

• Withdraw antihypertensives that do not reduce proteinuria and continue those that do
• Discontinue all antihypertensives if SBP is consistently < 130 mmHg, prioritizing fall prevention
• Gradually reduce the dose of all antihypertensives while closely monitoring SBP
• Continue the current antihypertensive therapy without de-intensification
• Other