May 9, 2017ENLIGHTEN (Jurnal Bimbingan dan Konseling Islam)Open Access

Withdrawal of antihypertensive medication

Q: What is the clinical evidence from this study?

Study design: Systematic Review. Population: Essential hypertension (n=2640). Intervention: Withdrawal of antihypertensive medication vs. Continuation of antihypertensive medication. Primary outcome: Proportion of people remaining below the study's threshold for hypertension treatment at 1 year (95% CI 0.40-0.40).

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Key result

Withdrawal of antihypertensive medication allowed 40% of patients to remain normotensive at 1 year and 26% at 2 years or longer, with only minor adverse events reported.

Why the study?

Does withdrawal of antihypertensive medication maintain normotension safely in adults with essential hypertension?

Population

Adults diagnosed with essential hypertension. 66 articles included in the systematic review, with 28 studies…

Comparison

Withdrawal of antihypertensive medication vs Continued antihypertensive medication or…

Design

Systematic_review

Follow-up

up to 2 years or longer

Authors

VWVeronika van der WardtUniversität Hamburg JHJennifer HarrisonEdinburgh Royal Infirmary TWTomas WelshAllen Institute for Brain Science

Discussion

Member takes

Implication

Supports deprescribing trials in selected patients; extends evidence for safe antihypertensive withdrawal.

Study Design

Type

Systematic Review (n=2,640)

Structured PICO

Does withdrawal of antihypertensive medication maintain normotension safely in adults with essential hypertension?

Population

A systematic review of adults with essential hypertension evaluating the proportion of patients who remain normotensive after withdrawal of antihypertensive medication for up to 2 years or longer.

Intervention

Withdrawal (cessation) of antihypertensive medication

Comparator

Continued antihypertensive medication (in studies with a control group) or baseline prior to withdrawal

Outcome

Proportion of people remaining normotensive (below each study's threshold for hypertension treatment) for 6 months or longer after cessation of antihypertensive therapysurrogate

Withdrawal of antihypertensive medication is feasible and safe in a subset of patients, with approximately 26% remaining normotensive at 2 years or longer.

Limitations

Many of the included studies were small and had short follow-up periods.
Studies used different thresholds for defining hypertension.
Did not identify potential long-term risks such as cardiovascular or cerebrovascular events.
Limited evidence regarding the withdrawal of specific types of antihypertensive treatments like renin inhibitors or calcium antagonists.
Findings may not generalize to patients at high vascular risk.
Many studies were small
Short follow-up period
Used different thresholds for hypertension
Did not identify potential long-term risks such as cardiovascular or cerebrovascular events
Excluded patients at high vascular risk

Cite This Study

Wardt et al. (2017) conducted a systematic review in Essential hypertension (n=2,640). Withdrawal of antihypertensive medication vs. Continuation of antihypertensive medication was evaluated on Proportion of people remaining below the study's threshold for hypertension treatment at 1 year (95% CI 0.40-0.40). Withdrawal of antihypertensive medication allowed 40% of patients to remain normotensive at 1 year and 26% at 2 years or longer, with only minor adverse events reported.

synapsesocial.com/papers/6a6f4cfd26770c2b8ddfed27 https://doi.org/10.1097/hjh.0000000000001405

Topics

Hypertension management

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Withdrawal of antihypertensive medication

Discussion

Member takes

Implication

Study Design

Structured PICO

Limitations

Cite This Study

Topics

Withdrawal of antihypertensive medication

Discussion

Member takes

Implication

Study Design

Structured PICO

Limitations

Cite This Study

Also Consider

Topics

Also Consider