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Discontinuing therapy — Some patients with stage 1 hypertension are well controlled,
often on a single medication. After a period of years, the question arises as to whether
antihypertensive therapy can be gradually diminished or even discontinued.
After discontinuation of treatment, a substantial proportion of patients remain
normotensive for at least one to two years [
61
]; a larger fraction of patients do well with a
decrease in the number and/or dose of medications taken [
62,63
].
More gradual tapering of drug dose is indicated in well-controlled patients taking multiple
drugs [
64
]. (See
"Can drug therapy be discontinued in well-controlled hypertension?"
.)
Abrupt cessation of some antihypertensive drugs, especially higher doses of short-acting
beta blockers (such as
propranolol
) or the short-acting alpha-2 agonist (
clonidine
) can lead
to a potentially fatal withdrawal syndrome. Gradual discontinuation of these agents over a
period of weeks should prevent this problem. (See
"Withdrawal syndromes with
antihypertensive drug therapy"
.)
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