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Some Patients Can Discontinue Hypertension Drugs

By HospiMedica staff writers
Posted on 08 Mar 2001
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Forty-two percent of patients whose hypertension medicine was discontinued were likely to maintain normal blood pressure for more than a year, according to a study in the February issue of the American Journal of Hypertension, a publication of the American Society of Hypertension. The study was conducted by researchers at Alfred Hospital (Prahran, Australia).

The investigators noted that some doctors have difficulty in selecting patients for medication withdrawal and have concerns about patient safety and legal liability. Those most likely to be successfully withdrawn from medication are those with mildly elevated uncomplicated blood pressure that has been controlled by one medication. Patients must be carefully screened before they are selected and must be motivated and willing to accept lifestyle changes if needed.

The recommendations were based on an analysis of 12 major studies focusing on the withdrawal of antihypertensive therapy since the 1950s. When therapy is withdrawn, it is crucial, said the researchers, to start and continue long-term monitoring of patients in order to detect any return of high blood pressure. They speculate that most patients for whom withdrawal is appropriate may be those in whom therapy was commenced inappropriately. Because of this, it is important to confirm the diagnosis before starting treatment.

The U.S. Joint National Committee on the Detection, Evaluation, and Treatment of High Blood Pressure recommends that a decision to treat mild-to-moderate blood pressure elevation should be based on at least two blood pressure readings on at least three separate occasions.



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