Evidence map›Paper›PMID 28486271›Full record

SynthesisJournal of hypertension2017

Withdrawal of antihypertensive medication: a systematic review.

Veronika van der Wardt, Jennifer K Harrison, Tomas Welsh, Simon Conroy, John Gladman

Registry-linked trialAbstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Journal of hypertension, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04515095 (A Safety and Feasibility Study of Water-only Fasting and Refeeding for Treatment of Stage 1 and 2 Hypertensive Patients), which is not on this map. Cited by 37 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
37citing papers in PubMed, 3 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04515095 nacompletednot on this mapstarted 2020, after this paper: background citation

A Safety and Feasibility Study of Water-only Fasting and Refeeding for Treatment of Stage 1 and 2 Hypertensive Patients

TypeinterventionalSponsorTrueNorth Health FoundationRan2020 to 2022Enrolled30ConditionsHypertensionArmsWater-only Fasting
3 · Its place in the literature

Who cites it

37 citing papers in PubMed, 3 syntheses or guidelines pooled it.

  1. Withdrawal of antihypertensive drugs in older people.The Cochrane database of systematic reviews · 2025
    Pooled it
  2. Pooled it
  3. Withdrawal of antihypertensive drugs in older people.The Cochrane database of systematic reviews · 2020
    Pooled it
  4. Trial
  5. Trial
  6. Trial
  7. Trial
  8. [Developmental trajectories of medication adherence and predictors of latent classes in patients with ischemic stroke].Zhong nan da xue xue bao. Yi xue ban = Journal of Central South University. Medical sciences · 2026
    Article
  9. Observational
  10. The Japanese Society of Hypertension Guidelines for the management of elevated blood pressure and hypertension 2025 (JSH2025).Hypertension research : official journal of the Japanese Society of Hypertension · 2026
    Article
  11. Article
  12. Article
  13. Mechanism-based therapy of non-cardiac syncope: a practical guide.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2024
    Article
  14. Article
  15. Interventions aimed to increase average 24-h systolic blood pressure reduce blood pressure drops in patients with reflex syncope and orthostatic intolerance.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2024
    Observational
  16. Article
  17. Article
  18. Article
  19. Article
  20. Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

5 authors.

Veronika van der WardtaDivision of Rehabilitation and Ageing, School of Medicine, University of Nottingham, Nottingham bCentre for Cognitive Ageing and Cognitive Epidemiology & The Alzheimer Scotland Dementia Research Centre, Royal Infirmary of Edinburgh, Edinburgh cRICE (Research Institute for the Care of Older People), Royal United Hospital, Bath dDepartment of Health Sciences, University of Leicester, Leicester, United Kingdom.
Jennifer K Harrison
Tomas Welsh
Simon Conroy
John Gladman

Funding

Department of Health PB-PG-1112-29070
6 · The paper itself

Abstract

: Although antihypertensive medication is usually continued indefinitely, observations during wash-out phases in hypertension trials have shown that withdrawal of antihypertensive medication might be well tolerated to do in a considerable proportion of people. A systematic review was completed to determine the proportion of people remaining normotensive for 6 months or longer after cessation of antihypertensive therapy and to investigate the safety of withdrawal. The mean proportion adjusted for sample size of people remaining below each study's threshold for hypertension treatment was 0.38 at 6 months [95% confidence interval (CI) 0.37-0.49; 912 participants], 0.40 at 1 year (95% CI 0.40-0.40; 2640 participants) and 0.26 at 2 years or longer (95% CI 0.26-0.27; 1262 participants). Monotherapy, lower blood pressure before withdrawal and body weight were reported as predictors for successful withdrawal. Adverse events were more common in those who withdrew but were minor and included headache, joint pain, palpitations, oedema and a general feeling of being unwell. Prescribers should consider offering patients with well controlled hypertension a trial of withdrawal of antihypertensive treatment with subsequent regular blood pressure monitoring.

Indexed as

Antihypertensive AgentsHypertensionHumansAntihypertensive Agents

Identifiers

PMID28486271
PMCPMC5548513

What OpenQuestion holds

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LicenceCC BY
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.