This issue is about the elderly and discontinuation of antihypertensive medication.
I am not taking antihypertensive medication, but my parents and other elderly people I dealt with in the clinical field continue to take it because their blood pressure is too high and they need to take medication to lower it.At that time, I didn't have the knowledge or qualifications for this kind of medical treatment, so I was told that if I didn't continue to take them, my risk of heart disease would increase.Is that really true? I was wondering if this was really true, and I found a review that might be helpful.
The study
This is a review of six studies that included a total of 1,073 elderly people.
The average age of the study subjects ranged from 58 to 82 years.Three of the studies involved interventions that involved slowly reducing the dose of antihypertensive medication before discontinuing it.What we learned from the included participants is that it is possible to stop antihypertensive medication.And most of the elderly in the discontinued group did not need to resume their medication.The participants in this group reported a slight increase in blood pressure after stopping the antihypertensive medication, although the evidence was less certain.However, we found with less certainty that stopping the medication did not increase the risk of heart attack, stroke, hospitalization, or death.
We found very low certainty in the evidence that stopping blood pressure medication does not increase the risk of adverse events and may resolve side effects, but this was not well reported and we could not draw any conclusions.No studies reported whether discontinuation of antihypertensive medication had an effect.
Reviewer's conclusion
There is no evidence of an effect of discontinuing compared with continuing antihypertensives used for hypertension or primary prevention of There is no evidence of an effect of discontinuing compared with continuing antihypertensives used for hypertension or primary prevention of cardiovascular disease in older adults on all-cause mortality and myocardial infarction. The evidence was low to very low certainty mainly due to small studies and low event The evidence was low to very low certainty mainly due to small studies and low event rates. These limitations mean that we cannot make any firm conclusions about the effect of deprescribing These limitations mean that we cannot make any firm conclusions about the effect of deprescribing antihypertensives on these outcomes. Future research should focus on populations with the greatest uncertainty of the benefit:risk ratio for use of antihypertensive medications, such as those with frailty, older age groups and those taking polypharmacy, and measure clinically important outcomes and measure clinically important outcomes such as falls, quality of life and adverse drug events.
Reeve E, Jordan V, Thompson W, Sawan M, Todd A, Gammie TM, Hopper I, Hilmer SN, Gnjidic D. Withdrawal of antihypertensive drugs in older people. Database of Systematic Reviews 2020, Issue 6. Art. No.: CD012572. DOI: 10.1002/14651858.CD012572.pub2.
Summary
It seems that there were few cases of serious problems reported in the process of gradual reduction and discontinuation of medications.It's called prevention, but is it really? However, since there is also the management of underlying diseases, I wonder if it is a good idea to encourage people to stop the drug easily. I wondered if it would be a good idea to encourage people to stop taking it.In the end, it is up to you to discuss with your doctor who is managing your condition, but if it is painful for you to take the medicine, why don't you tell him how you feel about it?If I had to take them, depending on the type of disease, I might consider taking the medication itself.
However, please don't restrict yourself from taking the medication just because of this review.
