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Is a hypertensive always a hypertensive?

S Wahi¹, S Sagar, B K Sharma

¹Department of Internal medicine, Postgraduate Institute of Medical Education and Research, Chandigarh.

The Journal of the Association of Physicians of India

|April 1, 1993

Summary

In essential hypertension patients, withdrawing medication under observation may allow some to remain drug-free. However, a significant dropout rate highlights the need for careful monitoring and highlights economic implications.

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Area of Science:

Cardiology
Clinical Pharmacology

Background:

Essential hypertension affects a large global population.
Long-term management of hypertension often involves continuous medication.
The possibility of discontinuing antihypertensive therapy is an area of clinical interest.

Purpose of the Study:

To evaluate the feasibility and outcomes of withdrawing antihypertensive therapy in patients with stable, uncomplicated essential hypertension.
To assess the rate of sustained normotension after drug withdrawal.
To identify potential risks and benefits associated with therapy discontinuation.

Main Methods:

A prospective follow-up study of 42 patients with stable essential hypertension.
Antihypertensive drug therapy was withdrawn for a 2-year observation period.
Patients were monitored for blood pressure control, and therapy was reinstituted if hypertension recurred.
Data on drug-free status, need for retreatment, and drop-out rates were collected.

Main Results:

Initially, a high percentage of patients remained normotensive at 4 and 8 weeks post-withdrawal (89.9% and 33 patients, respectively).
At 2 years, 14 patients (33.3%) were drug-free, 15 (35.7%) required retreatment, and 13 (30.9%) were lost to follow-up.
No cardiovascular or other complications were reported during the study period.

Conclusions:

A subgroup of patients with mild or moderate essential hypertension may be able to discontinue therapy under medical supervision.
A substantial dropout rate was observed, suggesting potential challenges in long-term adherence or follow-up.
The findings have significant economic and therapeutic implications for hypertension management globally.

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