To assess the feasibility of discontinuing antihypertensive therapy in patients with uncomplicated hypertension who maintain normal blood pressure, highlighting the implications for current hypertension management.
Key Findings:
36% of patients maintained normotension (<135/85 mmHg) after 1 year post-treatment withdrawal, suggesting potential for treatment discontinuation in low-risk patients.
Low baseline home BP was associated with higher likelihood of maintaining normotension, indicating the importance of initial BP assessment.
Only one ischemic stroke occurred during follow-up in a patient with home BP >120/80 mmHg, suggesting low risk during monitoring.
Use of angiotensin-receptor blockers (ARBs) was positively associated with normotension persistence, indicating a potential treatment strategy.
Interpretation:
Discontinuation of antihypertensive treatment is feasible in selected low-risk patients with Grade 1 hypertension and low home BP, emphasizing the need for periodic monitoring to ensure patient safety and treatment efficacy.
Limitations:
Only 55% of participants had repeated BP measurements at three consultations, which may limit the reliability of findings.
No significant differences in out-of-office measurements between those who maintained normotension and those who did not, challenging the assumption of misclassification.
Conclusion:
The study suggests that patients with low cardiovascular risk and Grade 1 hypertension may not require ongoing antihypertensive treatment if they maintain low home BP, underscoring the importance of accurate diagnosis and continuous monitoring for effective hypertension management.
