A 5-year prospective, observational study of the withdrawal of antihypertensive treatment in elderly people.
OBJECTIVE
To observe blood pressure, cardiovascular events, and total mortality after withdrawing antihypertensive treatment for elderly patients.


METHODS
Multicentre observational study.


METHODS
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.


METHODS
After withdrawal of the antihypertensive therapy, all patients started in the untreated state and during the 5-year follow-up they could then either remain in the untreated state, or be reverted to blood-pressure-lowering drug treatment because of hypertension or other diseases, e.g. angina pectoris, oedema, congestive heart failure, etc.


RESULTS
The probability of remaining without treatment for 5 years was estimated to be 20%. During the state of no treatment the patients had a lower total mortality risk than that of the general Swedish population, matched for age and sex. They also had a lower risk of cardiovascular events than those in the treated states. Markers indicating a successful withdrawal were monotherapy in low doses and relatively low blood pressure before withdrawal.


CONCLUSIONS
These results suggest that with frequent check-ups, withdrawal of antihypertensive therapy in the elderly can be tried without increased risk of cardiovascular events.
Ekbom
T
T
Health Sciences Centre, Lund University, Dalby/Lund, Sweden.
Lindholm
L H
LH
Odén
A
A
Dahlöf
B
B
Hansson
L
L
Wester
P O
PO
Scherstén
B
B
D000368:Aged; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000401:mortality; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D008297:Male; D011446:Prospective Studies; D012307:Risk Factors
D000959:Antihypertensive Agents