Prolonged normotension following cessation of therapy in uncomplicated essential hypertension

Abstract

The blood pressure levels of 17 men and 7 women aged 27-65 years with uncomplicated essential hypertension were studied during and after withdrawal of antihypertensive therapy. Medication during the treatment phase included diuretics alone (13 patients), diuretic-nondiuretic combinations (5 patients), and nondiuretics alone (6 patients). Blood pressures were followed: greater than 48 weeks (with therapy) vs greater than 48 weeks (without therapy). SBP rose significantly (P less than 0.05) after therapy withdrawal but remained, for all but 6 of the 24, within the normotensive range (SBP mean +/- S.D. 125.2 +/- 11.1 mm Hg vs 134.9 +/- 13.3 mm Hg, and erect 87.4 +/- 9.3 mm Hg vs 131.2 +/- 12.0 mm Hg). DBP was unchanged (DBP mean +/- S.D., supine 83.8 +/- 8,0 mm Hg vs 85.2 +/- 6.2 mm Hg, and erect 87.4 +/- 9.3 mm Hg vs 86.7 +/- 6.6 mm Hg, P = 0.174). The blood pressures of 6 patients (25%) rose to levels requiring medication (SBP greater than 140 mm Hg. DBP greater than 95 mm Hg) between weeks 49 and 60. Salt intake was low (less than 100 mmol 24 h-1) and body weight remained stable (mean 75.4 +/- 12.4 kg vs 77.2 +/- 13.0 kg). These observations my indicate a role for intermittent antihypertensive therapy or quantitative reduction of medications, in the control of uncomplicated essential hypertension, provided that careful follow-up is available.