Key result
Withdrawal of antihypertensive treatment in 70-year-old patients without cardiovascular disease significantly increased blood pressure but caused no clinical signs of congestive heart failure.
Why the study?
Does withdrawal of antihypertensive treatment affect blood pressure and cardiovascular function in 70-year-old patients without signs of cardiovascular disease?
Cohort (n=619)
Does withdrawal of antihypertensive treatment affect blood pressure and cardiovascular function in 70-year-old patients without signs of cardiovascular disease?
Withdrawal of antihypertensive treatment in healthy 70-year-olds leads to increased blood pressure and decreased fractional shortening, but no overt heart failure or adverse morphological changes over 2 years.
May support short-term withdrawal without HF in low-risk elderly; hypothesis-generating, requiring RCTs before practice change.
In a representative population sample of 619 70-year-old people, 26% were taking antihypertensive treatment. Twenty per cent (n = 32) of them showed no signs of cardiovascular disease and had a blood pressure of less than 175/95 mmHg. Treatment was withdrawn in 25 of the 32 patients. Casual blood pressure, blood pressure during isometric exercise and left ventricular morphology and function were studied repeatedly over 2 years, using non-invasive methods. A significant increase in mean systolic and diastolic blood pressures was observed in the 14 patients who completed the study. No change was observed with respect to left ventricular morphology and left ventricular diastolic function. A statistically significant decrease in left ventricular fractional shortening, but no clinical signs of congestive heart failure were observed. Withdrawal of antihypertensive treatment in elderly patients free from signs of cardiovascular disease may thus be attempted without harmful effects on cardiovascular function.
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Lernfelt et al. (1990) conducted a cohort in Hypertension (n=619). Withdrawal of antihypertensive treatment was evaluated on Casual blood pressure, blood pressure during isometric exercise and left ventricular morphology and function. Withdrawal of antihypertensive treatment in 70-year-old patients without cardiovascular disease significantly increased blood pressure but caused no clinical signs of congestive heart failure.
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