[Withdrawal of antihypertensive treatment]

Research over the years has given considerable evidence that medically induced normalization of the blood pressure in hypertensive patients decreases cardiac and cerebrovascular morbidity. On the other hand, few studies have attempted to evaluate the consequences of a subsequent withdrawal of anti-hypertensive treatment. This paper assesses the research in this field and concludes that approximately 20-25% of patients with mild hypertension remain normotensive during a follow-up period of 1-2 years. Based on this conclusion, the following is recommended: in patients with well treated, mild hypertension, who have been normotensive for a minimum of two years, withdrawal of antihypertensive treatment could be attempted followed by monthly measurements of blood pressure. Concurrent non-pharmacological intervention is recommended. Sequential antihypertensive therapy may thus be an alternative to the currently established strategy of life-long treatment.