T. Ekbom et al., A 5-YEAR PROSPECTIVE, OBSERVATIONAL STUDY OF THE WITHDRAWAL OF ANTIHYPERTENSIVE TREATMENT IN ELDERLY PEOPLE, Journal of internal medicine, 235(6), 1994, pp. 581-588
Objectives. To observe blood pressure, cardiovascular events, and tota
l mortality after withdrawing antihypertensive treatment for elderly p
atients. Design. Multicentre observational study. Setting. Sweden, A 5
-year follow-up of 333 elderly hypertensive patients, aged 70-84 years
(mean age 75.2 +/- SD 3.8 years, 68% females). In all, 74 out of the
333 patients (22%) died during the study period. Method. After withdra
wal of the antihypertensive therapy, all patients started in the untre
ated state and during the 5-year follow-up they could then either rema
in in the untreated state, or be reverted to blood-pressure-lowering d
rug treatment because of hypertension or other diseases, e.g. angina p
ectoris, oedema, congestive heart failure, etc. Results. The probabili
ty of remaining without treatment for 5 years was estimated to be 20%.
During the state of no treatment the patients had a lower total morta
lity risk than that of the general Swedish population, matched for age
and sex. They also had a lower risk of cardiovascular events than tho
se in the treated states. Markers indicating a successful withdrawal w
ere monotherapy in low doses and relatively low blood pressure before
withdrawal. Conclusion. These results suggest that with frequent check
-ups, withdrawal of antihypertensive therapy in the elderly can be tri
ed without increased risk of cardiovascular events.