Why the study?
Does withdrawal of different antihypertensive drugs cause immediate adverse effects on heart rate and blood pressure in patients?
Does withdrawal of different antihypertensive drugs cause immediate adverse effects on heart rate and blood pressure in patients?
Abrupt withdrawal of clonidine or postganglionic neurone-blocking drugs carries a high risk of rebound hypertension and arrhythmias compared to methyldopa or beta-blockers.
Clonidine withdrawal may trigger rebound hypertension and ectopy; observational data leaves open need for RCTs before changing practice.
The immediate effects on heart rate and blood pressure of withdrawing antihypertensive drugs were studied over three-day periods in 26 patients. Four groups of drugs were studied. After withdrawal all patients taking clonidine showed a considerable increase in heart rate and blood pressure with intense ectopic activity. Patients taking postganglionic neurone-blocking drugs showed a similar but less pronounced reaction with increased ventricular ectopic activity. No alarming reactions were seen after withdrawal of methyldopa or beta-blocking drugs. Methyldopa and, especially, beta-blocking drugs are less likely to produce withdrawal reactions than clonidine or the postganglionic neurone-blocking drugs, and patients taking these drugs are therefore less likely to suffer violent reactions if they forget to take their tablets.
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Goldberg et al. (1977) studied this question.
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