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Research ArticleOriginal Article

Withdrawal of Antihypertensive Medications

Jack Froom, Jeffrey S. Trilling, Shing-shing Yeh, Irving H. Gomolin, Anne-Marie Filkin and Roger C. Grimson
The Journal of the American Board of Family Practice July 1997, 10 (4) 249-258; DOI: https://doi.org/10.3122/jabfm.10.4.249
Jack Froom
From the Department of Family Medicine, State University of New York at Stony Brook. Address reprint requests to Jack Froom, MD, Department of Family Medicine, Health Science Center, State University of New York at Stony Brook, Stony Brook, NY 11794-8461
MD
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Jeffrey S. Trilling
From the Department of Family Medicine, State University of New York at Stony Brook. Address reprint requests to Jack Froom, MD, Department of Family Medicine, Health Science Center, State University of New York at Stony Brook, Stony Brook, NY 11794-8461
MD
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Shing-shing Yeh
From the Department of Family Medicine, State University of New York at Stony Brook. Address reprint requests to Jack Froom, MD, Department of Family Medicine, Health Science Center, State University of New York at Stony Brook, Stony Brook, NY 11794-8461
MD, PhD
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Irving H. Gomolin
From the Department of Family Medicine, State University of New York at Stony Brook. Address reprint requests to Jack Froom, MD, Department of Family Medicine, Health Science Center, State University of New York at Stony Brook, Stony Brook, NY 11794-8461
MDCM
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Anne-Marie Filkin
From the Department of Family Medicine, State University of New York at Stony Brook. Address reprint requests to Jack Froom, MD, Department of Family Medicine, Health Science Center, State University of New York at Stony Brook, Stony Brook, NY 11794-8461
MD
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Roger C. Grimson
From the Department of Family Medicine, State University of New York at Stony Brook. Address reprint requests to Jack Froom, MD, Department of Family Medicine, Health Science Center, State University of New York at Stony Brook, Stony Brook, NY 11794-8461
PhD
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Abstract

Background: Pharmacologic treatment of hypertension reduces risks of stroke, congestive heart failure, renal failure, and mortality, but whether medications, once begun, need to be continued for life is uncertain.

Methods: Several search strategies on MEDLINE using key words “medication,” “withdrawal,” “discontinuance,” and “therapy” in several combinations, nested within “hypertension,” were not productive. Accordingly, articles known to the authors and citations within them were reviewed. A survey of a random sample of members of the New York Academy of Family Practice was conducted to ascertain current practice of practicing physicians.

Results: Eighteen studies of antihypertensive medication withdrawal were located and all were reviewed. In 12 trials average success rates of 40.3 percent after 1 year of follow-up and 27.7 percent after 2 years were achieved. In six studies limited to elderly patients, an average success rate of 26.2 percent was obtained for periods of 2 or more years. The trials, however, were heterogeneous in design, patient selection criteria, and follow-up. The survey of family physicians indicated that 79.1 percent attempt withdrawal of antihypertensive medications in hypertensive patients whose blood pressure is controlled and who are without symptoms from medication.

Conclusions: We conclude that successful withdrawal of antihypertensive medications can have substantial benefits with few or no adverse consequences and might be successful in about one third of patients. Additional research is required to substantiate rates of successful medication withdrawal, to define the best method of withdrawing medications, and to delineate characteristics of patients in whom withdrawal is most likely to succeed.

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The Journal of the American Board of Family     Practice: 10 (4)
The Journal of the American Board of Family Practice
Vol. 10, Issue 4
1 Jul 1997
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Withdrawal of Antihypertensive Medications
Jack Froom, Jeffrey S. Trilling, Shing-shing Yeh, Irving H. Gomolin, Anne-Marie Filkin, Roger C. Grimson
The Journal of the American Board of Family Practice Jul 1997, 10 (4) 249-258; DOI: 10.3122/jabfm.10.4.249

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Withdrawal of Antihypertensive Medications
Jack Froom, Jeffrey S. Trilling, Shing-shing Yeh, Irving H. Gomolin, Anne-Marie Filkin, Roger C. Grimson
The Journal of the American Board of Family Practice Jul 1997, 10 (4) 249-258; DOI: 10.3122/jabfm.10.4.249
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