For how we live.
The largest meta-analysis puts the incidence attributable to the drug at about 15% — one in six or seven. Critics who reanalysed part of it put it above 50%. The gap is about what counts as evidence.
Reviewing and stopping unnecessary drugs in older people is safe in trials and reduces inappropriate prescriptions. Whether it makes them live longer or feel better is far less settled than the enthusiasm implies.
ABYSS and SMART-DECISION together cover 6,238 stable patients. Discontinuation cleared both noninferiority margins, though the authors say the primary endpoint's composition limits what it shows.
An individual-patient meta-analysis of 17,801 patients found a hazard ratio of 0.97 for death, reinfarction or heart failure — a result precise enough to make the question look settled.
The guidance is built on one negative instruction: do not stop abruptly in patients likely to be physically dependent. Hong Kong records show the sharpest prescribing rise in 18-to-25-year-olds.