Withdrawal of antihypertensive medication: a systematic review

van der Wardt, V., Harrison, J. K. , Welsh, T., Conroy, S. and Gladman, J. (2017) Withdrawal of antihypertensive medication: a systematic review. Journal of Hypertension, 35(9), pp. 1742-1749. (doi:10.1097/HJH.0000000000001405) (PMID:28486271) (PMCID:PMC5548513)

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Abstract

Although 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.

Item Type:Articles
Additional Information:The current article presents independent research funded by the National Institute for Health Research (NIHR) under its Research for Patient Benefit (RfPB) Programme (grant reference number PB-PG-1112-29070). The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health. J.G. was also funded by NIHR CLAHRC East Midlands. V.v.d.W., J.G., S.C. and J.K.H. report receiving a grant for this work from the National Institute of Health Research/United Kingdom.
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Burton, Dr Jenni
Authors: van der Wardt, V., Harrison, J. K., Welsh, T., Conroy, S., and Gladman, J.
College/School:College of Medical Veterinary and Life Sciences > Institute of Cardiovascular and Medical Sciences
Journal Name:Journal of Hypertension
Publisher:Lippincott, Williams & Wilkins
ISSN:0263-6352
ISSN (Online):1473-5598
Published Online:09 May 2017
Copyright Holders:Copyright © 2017 The Authors
First Published:First published in Journal of Hypertension 35(9):1742-1749
Publisher Policy:Reproduced under a Creative Commons License

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