The effect of withdrawing antihypertensive therapy: a review

In this report the effects of withdrawing antihypertensive medication are reviewed from case reports and randomized trials. Success, defined as the proportion of patients remaining normotensive after withdrawal of medication varied from 15% to over 50%. Factors that predicted the return of high blood pressure after withdrawal, however, included high level of pre-treated blood pressure, marked obesity, short duration of treatment and left ventricular hypertrophy (LVH). Male patients also tended to be more likely to return to having high blood pressure than female patients. In community studies, it is predicted that many subjects will not be suitable candidates for withdrawal or treatment in view of their high blood pressures (both treated and pre-treated), obesity, and also their unwillingness to stop therapy.