Can drug therapy be discontinued in well-controlled hypertension?
- William J Elliott, MD, PhD
William J Elliott, MD, PhD
- Professor of Preventive Medicine, Internal Medicine and Pharmacology
- Head, Division of Pharmacology
- Chair, Department of Biomedical Sciences
- Pacific Northwest University of Health Sciences, Yakima, WA
- Section Editor
- George L Bakris, MD
George L Bakris, MD
- Editor-in-Chief — Nephrology
- Section Editor — Hypertension
- Professor of Medicine
- The University of Chicago
- Deputy Editors
- Daniel J Sullivan, MD, MPH
Daniel J Sullivan, MD, MPH
- Deputy Editor — Primary Care (Adult)
- Assistant Professor of Medicine
- Harvard Medical School
- John P Forman, MD, MSc
John P Forman, MD, MSc
- Senior Deputy Editor — UpToDate
- Deputy Editor — Nephrology
- Assistant Professor of Medicine
- Harvard Medical School
The large majority of patients with hypertension will require lifelong antihypertensive drug therapy to control their blood pressure. However, some patients with hypertension have well-controlled blood pressures, occasionally needing just a single medication. After a year below the target blood pressure, many wonder whether antihypertensive drug therapy can be gradually diminished or even discontinued. The issue of discontinuation of drug therapy also arises in patients who develop symptoms related to low blood pressure.
Discontinuation of antihypertensive drug therapy in patients with controlled blood pressure is discussed in this topic. Withdrawal syndromes that may develop as a result of drug discontinuation are presented elsewhere. (See "Withdrawal syndromes with antihypertensive therapy".)
IDENTIFYING PATIENTS FOR ANTIHYPERTENSIVE DRUG WITHDRAWAL
Identifying candidates for drug withdrawal — Diminishing or discontinuing antihypertensive medication may be possible among patients with hypertension that is well controlled for at least one year [1-4].
Among such patients in one study, approximately 40 percent remained free from antihypertensive drugs at one year after discontinuation [1,4], and approximately 25 percent remained off therapy at two years . A larger fraction can successfully decrease the number and/or dose of medications taken [1,3,5].
Higher success rates for cessation of antihypertensive therapy are seen in individuals with the following characteristics:To continue reading this article, you must log in with your personal, hospital, or group practice subscription. For more information on subscription options, click below on the option that best describes you:
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- IDENTIFYING PATIENTS FOR ANTIHYPERTENSIVE DRUG WITHDRAWAL
- Identifying candidates for drug withdrawal
- How to diminish or discontinue antihypertensive drug therapy
- MECHANISMS OF SUCCESSFUL ANTIHYPERTENSIVE DRUG WITHDRAWAL
- Lifestyle modifications
- Excessive doses
- WITHDRAWAL SYNDROMES
- SOCIETY GUIDELINE LINKS