Clinical evidence demonstrates that carefully supervised reduction of blood pressure medications in nursing home residents can be accomplished without adverse cardiovascular events. The intervention targeted patients on multiple antihypertensive agents, systematically reducing dosages while monitoring for safety signals including falls, cognitive changes, and cardiovascular complications. This approach challenges the conventional wisdom of aggressive blood pressure control in elderly populations, particularly those in institutional care settings. The findings align with growing recognition that medication burden often outweighs benefits in frail older adults, where polypharmacy contributes to falls, cognitive impairment, and reduced quality of life. For nursing home residents, who typically have limited life expectancy and multiple comorbidities, the risk-benefit calculus differs substantially from community-dwelling adults. The research supports a more nuanced approach to hypertension management in advanced age, prioritizing functional status and symptom burden over numerical targets. This represents a significant shift toward deprescribing strategies in geriatric medicine, though implementation requires careful individualized assessment and close monitoring protocols to ensure patient safety during medication transitions.