withdrawal of antihypertensive therapy: unlikely to be of major clinical or economical significance

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Withdrawal of antihypertensive therapy: unlikely to be of major clinical or economical significance Drug therapy of hypertension is commonly lifelong , and may be associated with adverse effects which reduce patient quality of life. Several studies have assessed the effects of withdrawing antihypertensive agents. 15-74"10 of previously hypertensive patients were normotensive for 12-36 months after antihypertensive treatment withdrawal, compared with 75-97"10 of patients who continued to receive active drug therapy. Dietary advice, given upon drug withdrawal, has been shown to reduce the number of patients requiring reinstitution of antihypertensive therapy compared with drug withdrawal alone. The relationships between return of hypertension after treatment withdrawal and pretreatment and treatment BPs, therapy duration, bodyweight, left ventricular hypertrophy, type of therapy, and demographic variables such as age, sex and race, have been studied . Pretreatment BP , treated BP , obesity, male se x and black ethnic origin have been correlated with an increased risk of becoming hypertensive following treatment withdrawal. Age and therapy do not appear to be predictors of response to therapy withdrawal. Although several studies have found duration of treatment to have no effect on return to elevated BP after antihypertensive withdrawal, 1 showed a slower return of hypertension in patients who had received longer treatments. Serum potassium increases in response to withdrawal of thiazide and related diuretics. Serum uric acid reduction and modification of certain biochemical risk factors for cardiovascular disease have also been noted with thiazide withdrawal. In conclusion , 'patients who are likely to remain normotensive are non-overweight women with normal ventricular mass and untreated blood pressures In the mild hypertensive range, and with well controlled hypertension, treated for several years'. Mortality and morbidity after therapy withdrawal requires determination in long-term studies. Fl el r: her AE. Franks PJ. Bulpitt CJ. The effect of withdr awing antihypertenSive therapy a review. Journal of H ypertension 6 43 t 0436 . Jun " 1988 0156-2703/ 88/ 7277 -0003/ 0$07 .00/ 0 © ADIS Press INPHARMA ' 77 Dec 7 988 3

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Page 1: Withdrawal of antihypertensive therapy: unlikely to be of major clinical or economical significance

Withdrawal of antihypertensive therapy: unlikely to be of major clinical or economical significance

Drug therapy of hypertension is commonly lifelong , and may be associated with adverse effects which reduce patient quality of life.

Several studies have assessed the effects of withdrawing antihypertensive agents . 15-74"10 of previously hypertensive patients were normotensive for 12-36 months after antihypertensive treatment withdrawal, compared with 75-97"10 of patients who continued to receive active drug therapy.

Dietary advice, given upon drug withdrawal , has been shown to reduce the number of patients requiring reinstitution of antihypertensive therapy compared with drug withdrawal alone.

The relationships between return of hypertension after treatment withdrawal and pretreatment and treatment BPs, therapy duration, bodyweight , left ventricular hypertrophy, type of therapy, and demographic variables such as age, sex and race, have been studied . Pretreatment BP, treated BP, obesity, male sex and black ethnic origin have been correlated with an increased risk of becoming hypertensive following treatment withdrawal. Age and therapy do not appear to be predictors of response to therapy withdrawal.

Although several studies have found duration of treatment to have no effect on return to elevated BP after antihypertensive withdrawal, 1 showed a slower return of hypertension in patients who had received longer treatments. Serum potassium increases in response to withdrawal of thiazide and related diuretics. Serum uric acid reduction and modification of certain biochemical risk factors for cardiovascular disease have also been noted with thiazide withdrawal. In conclusion , 'patients who are likely to remain

normotensive are non-overweight women with normal ventricular mass and untreated blood pressures In the mild hypertensive range, and with well controlled hypertension, treated for several years'. Mortality and morbidity after therapy withdrawal requires determination in long-term studies. Flelr:her AE. Franks PJ. Bulpi tt CJ. The effect of wi thdrawing antihypertenSive therapy a review . Journal of H ypertension 6 43 t 0436 . Jun " 1988

0156-2703/ 88/ 7277-0003/ 0$07 .00/ 0 © ADIS Press INPHARMA ' 77 Dec 7 988 3