A 5-year prospective, observational study of the withdrawal of antihypertensive treatment in elderly people.

OBJECTIVES

To observe blood pressure, cardiovascular events, and total mortality after withdrawing antihypertensive treatment for elderly patients.

DESIGN

Multicentre observational study.

SETTING

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.

METHOD

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.

RESULTS

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.

CONCLUSION

These results suggest that with frequent check-ups, withdrawal of antihypertensive therapy in the elderly can be tried without increased risk of cardiovascular events.