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[Behavior of the night decrease of arterial pressure after suppression controlled of the antihypertensive
F Villalba Alcalá1, A Espino Montoro, C Alvarez Lacayo
1Doctor en Medicina. Médico de Familia. Servicio de Cuidados Críticos y Urgencias del Hospital de La Merced. Osuna. Sevilla. España. franvillalba81@hotmail.com
Atencion Primaria
|April 12, 2003
Summary
Discontinuing antihypertensive medication in well-controlled hypertension did not alter the percentage of patients who are "dippers" (showing a normal night-time blood pressure decrease). This suggests medication withdrawal does not significantly impact this cardiovascular risk indicator.
Area of Science:
- Cardiology
- Hypertension Management
- Clinical Research
Background:
- Patients with hypertension lacking a normal night-time blood pressure decrease (non-dippers) exhibit increased target organ damage.
- Ambulatory blood pressure monitoring (ABPM) is crucial for assessing blood pressure patterns.
Purpose of the Study:
- To analyze the prevalence of the "dipper" status in patients with controlled Grade 1 or 2 hypertension after discontinuing antihypertensive medication.
- To evaluate changes in blood pressure patterns, specifically the "dipper" phenomenon, following medication withdrawal.
Main Methods:
- An observational, descriptive study involving 70 essential hypertensive patients with controlled blood pressure.
- ABPM was conducted in two phases: before and 4 weeks after suspending antihypertensive medication, with diurnal and nocturnal readings.
Main Results:
- 18 patients (26%) could not complete the study due to unacceptable blood pressure after medication withdrawal.
- 83% of patients remained "dippers" after medication suppression, with no significant gender-based differences in night-time blood pressure reduction.
- A majority of patients (75%) maintained their "dipper" or "non-dipper" status throughout the study.
Conclusions:
- Withdrawing antihypertensive medication in well-controlled Grade 1 or 2 hypertensive patients does not alter the proportion of individuals exhibiting normal night-time blood pressure decreases.
- The "dipper" status, a marker of cardiovascular risk, appears stable in this patient group upon short-term medication cessation.