Ekbom T, Lindholm L H, Odén A, Dahlöf B, Hansson L, Wester P O, Scherstén B
Health Sciences Centre, Lund University, Dalby/Lund, Sweden.
J Intern Med. 1994 Jun;235(6):581-8. doi: 10.1111/j.1365-2796.1994.tb01265.x.
To observe blood pressure, cardiovascular events, and total mortality after withdrawing antihypertensive treatment for elderly patients.
Multicentre observational study.
Sweden. A 5-year follow-up of 333 elderly hypertensive patients, aged 70-84 years (mean age 75.2 +/- SD 3.8 years, 68% females). In all, 74 out of the 333 patients (22%) died during the study period.
After withdrawal of the antihypertensive therapy, all patients started in the untreated state and during the 5-year follow-up they could then either remain in the untreated state, or be reverted to blood-pressure-lowering drug treatment because of hypertension or other diseases, e.g. angina pectoris, oedema, congestive heart failure, etc.
The probability of remaining without treatment for 5 years was estimated to be 20%. During the state of no treatment the patients had a lower total mortality risk than that of the general Swedish population, matched for age and sex. They also had a lower risk of cardiovascular events than those in the treated states. Markers indicating a successful withdrawal were monotherapy in low doses and relatively low blood pressure before withdrawal.
These results suggest that with frequent check-ups, withdrawal of antihypertensive therapy in the elderly can be tried without increased risk of cardiovascular events.
观察老年患者停用抗高血压治疗后的血压、心血管事件及总死亡率。
多中心观察性研究。
瑞典。对333名70 - 84岁（平均年龄75.2±标准差3.8岁，68%为女性）的老年高血压患者进行了5年随访。在研究期间，333名患者中有74名（22%）死亡。
停用抗高血压治疗后，所有患者开始处于未治疗状态，在5年随访期间，他们可以一直处于未治疗状态，或者因高血压或其他疾病（如心绞痛、水肿、充血性心力衰竭等）而恢复降压药物治疗。
估计有20%的患者能持续5年不接受治疗。在未治疗状态下，患者的总死亡风险低于年龄和性别匹配的瑞典普通人群。他们发生心血管事件的风险也低于接受治疗状态的患者。表明停药成功的指标是低剂量单药治疗和停药前相对较低的血压。
这些结果表明，通过频繁检查，可以尝试在老年患者中停用抗高血压治疗而不增加心血管事件风险。
