Withdrawal of antihypertensive medication: a systematic review

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 dete...

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Main Authors: van der Wardt, Veronika, Harrison, Jennifer K., Welsh, Tomas J., Conroy, Simon, Gladman, John R.F.
Format: Article
Published: Lippincott, Williams & Wilkins 2017
Subjects:
Online Access:https://eprints.nottingham.ac.uk/43774/
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author van der Wardt, Veronika
Harrison, Jennifer K.
Welsh, Tomas J.
Conroy, Simon
Gladman, John R.F.
author_facet van der Wardt, Veronika
Harrison, Jennifer K.
Welsh, Tomas J.
Conroy, Simon
Gladman, John R.F.
author_sort van der Wardt, Veronika
building Nottingham Research Data Repository
collection Online Access
description 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.
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spelling nottingham-437742020-05-04T18:45:23Z https://eprints.nottingham.ac.uk/43774/ Withdrawal of antihypertensive medication: a systematic review van der Wardt, Veronika Harrison, Jennifer K. Welsh, Tomas J. Conroy, Simon Gladman, John R.F. 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. Lippincott, Williams & Wilkins 2017-05-09 Article PeerReviewed van der Wardt, Veronika, Harrison, Jennifer K., Welsh, Tomas J., Conroy, Simon and Gladman, John R.F. (2017) Withdrawal of antihypertensive medication: a systematic review. Journal of Hypertension, 35 . ISSN 1473-5598 antihypertensive agents antihypertensive medication cessation hypertension withdrawal https://insights.ovid.com/crossref?an=00004872-900000000-97726 doi:10.1097/HJH.0000000000001405 doi:10.1097/HJH.0000000000001405
spellingShingle antihypertensive agents
antihypertensive medication
cessation
hypertension
withdrawal
van der Wardt, Veronika
Harrison, Jennifer K.
Welsh, Tomas J.
Conroy, Simon
Gladman, John R.F.
Withdrawal of antihypertensive medication: a systematic review
title Withdrawal of antihypertensive medication: a systematic review
title_full Withdrawal of antihypertensive medication: a systematic review
title_fullStr Withdrawal of antihypertensive medication: a systematic review
title_full_unstemmed Withdrawal of antihypertensive medication: a systematic review
title_short Withdrawal of antihypertensive medication: a systematic review
title_sort withdrawal of antihypertensive medication: a systematic review
topic antihypertensive agents
antihypertensive medication
cessation
hypertension
withdrawal
url https://eprints.nottingham.ac.uk/43774/
https://eprints.nottingham.ac.uk/43774/
https://eprints.nottingham.ac.uk/43774/