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Antihypertensive drug therapy withdrawal in a general population
Insights
Many hypertensive patients can successfully stop taking blood pressure medication. A study found 28% remained normotensive one year after withdrawal, suggesting millions could safely discontinue therapy.
Area of Science:
- Cardiology
- Clinical Pharmacy
Background:
- Hypertension management often involves long-term medication.
- Assessing medication withdrawal is crucial for patient outcomes and healthcare costs.
Purpose of the Study:
- To determine the proportion of hypertensive patients who can successfully discontinue antihypertensive medication.
- To identify predictors of successful medication withdrawal and long-term normotension.
Main Methods:
- A cohort of 157 hypertensive patients meeting specific blood pressure criteria had their medication withdrawn.
- Follow-up assessments at one and two years monitored blood pressure and need for reintroduction of therapy.
Main Results:
- Of 157 patients, 88 (56.1%) were eligible for drug interruption, and 66 (75%) had medication withdrawn.
- After one year, 69.8% of those with withdrawn medication remained normotensive; after two years, 54.5% did.
- Higher initial systolic blood pressure after one month predicted the need for reintroducing therapy.
Conclusions:
- Approximately 28% of the study population remained normotensive one year post-withdrawal.
- This suggests up to 5 million Americans could potentially interrupt antihypertensive therapy safely, avoiding drug-related risks and expenses.
Abstract:
To determine the fraction of all hypertensives who can be successfully withdrawn from antihypertensive medication, a study was conducted of a patient group originally drawn from a screened population of union members. Of 157 patients, 88 (56.1%) met preestablished blood pressure criteria for drug interruption, and 66 (75%) actually had medication withdrawn. Of these 66 patients, 69.8% and 54.5% followed up for one and two years, respectively, remained normotensive. Patients requiring reintroduction of antihypertensive therapy were distinguished from those remaining drug free by increased systolic blood pressure (141.4 +/- 13.2 vs 131.6 +/- 8.6 mm Hg) after one month. Extrapolation of the finding that 28% of the study population remained normotensive one year after drug therapy withdrawal suggests the possibility that as many as 5 million Americans currently taking antihypertensive drugs could have therapy interrupted for at least one year and thus avoid both the hazards and costs of drug therapy.