Antihypertensive therapy is not necessarily 'for life'

'Until now patients have been taught that hypertension means treatment for life.' However, many patients have made their own judgements, and most doctors are aware of patients who have stopped their antihypertensive medication and who have subsequently been normotensive. This phenomenon is compatible with evidence from 2 large studies, and with the evidence reported by Drs Aylett and Ketchin who successfully withdrew antihypertensive therapy from 8 of 9, albeit highly selected, patients [see Front page, this issue]. Dr Burton, of Surrey, UK, cautions that 'stopping treatment, however, could cause problems. We need to know the importance of any ensuing rise in blood pressure . .. ' Burton states that withholding the initiation of antihypertensive therapy until extended observation has been carried out could avoid many problems. The British Hypertension Society recommends that antihypertensive therapy be reserved for patients with a mean diastolic BP of ~ IOOmm Hg after regular observation during 3 months. 'Patients should no longer be told that treatment is necessaril}' for life: the possibility of reducing or stopping treatment should be mentioned at the outset.' Burton R. Withdrawing antihypertensive treatment. Hypertension may settle with time. British Medical Journal 303: 324-325. 10 Aug 1991 '385

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