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Withdrawal of antihypertensive medication: a systematic review.
journal contribution
posted on 2017-06-22, 13:03 authored by Veronika van der Wardt, Jennifer K. Harrison, Tomas Welsh, Simon Conroy, John GladmanAlthough antihypertensive medication is usually continued
indefinitely, observations during wash-out phases in
hypertension trials have shown that withdrawal of
antihypertensive medication might be well tolerated to do in
a considerable proportion of people. A systematic review
was completed to determine the proportion of people
remaining normotensive for 6 months or longer after
cessation of antihypertensive therapy and to investigate the
safety of withdrawal. The mean proportion adjusted for
sample size of people remaining below each study’s
threshold for hypertension treatment was 0.38 at 6 months
[95% confidence interval (CI) 0.37–0.49; 912 participants],
0.40 at 1 year (95% CI 0.40–0.40; 2640 participants) and
0.26 at 2 years or longer (95% CI 0.26–0.27; 1262
participants). Monotherapy, lower blood pressure before
withdrawal and body weight were reported as predictors for
successful withdrawal. Adverse events were more common
in those who withdrew but were minor and included
headache, joint pain, palpitations, oedema and a general
feeling of being unwell. Prescribers should consider offering
patients with well controlled hypertension a trial of
withdrawal of antihypertensive treatment with subsequent
regular blood pressure monitoring.
History
Citation
Journal of Hypertension, 2017, 35:000–000Author affiliation
/Organisation/COLLEGE OF MEDICINE, BIOLOGICAL SCIENCES AND PSYCHOLOGY/School of Medicine/Department of Health SciencesVersion
- VoR (Version of Record)
Published in
Journal of HypertensionPublisher
Wolters Kluwer Health, Inc.issn
0263-6352eissn
1473-5598Acceptance date
2017-04-17Copyright date
2017Available date
2017-06-22Publisher DOI
Publisher version
https://insights.ovid.com/crossref?an=00004872-900000000-97726Language
enAdministrator link
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