Antihypertensive therapy. To stop or not to stop?

摘要: The benefits of continuous antihypertensive therapy have been extensively documented. However, lack compliance with the prescribed regimen, excessive cost, and troublesome adverse effects some agents led to consideration intermittent or even complete discontinuation as an effective alternative lifelong medication. Prospective studies dealing this subject reported inconsistent results. Nevertheless, they allowed us identify selection criteria candidates for step-down therapy. Such include patients mild essential hypertension who one more following characteristics: young age, normal body weight, low salt intake, no alcohol consumption, pretreatment blood pressure, successful drug only, only minimal signs target organ damage. Stopping without subsequent rise in arterial pressure was shown be possible a subset period months years. This approach appears safe, provided that is monitored frequently, may improve compliance, save treatment costs, reduce certain drugs, although its long-term consequences morbidity mortality remain determined. ( JAMA . 1991;265:1566-1571)