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first 6 months following with- drawal of medication, but some individuals had return of hypertension even after 6 months.  It is important to keep in mind that blood pres- sure may rapidly escalate fol- lowing discontinuation of ther- apy, so called "rebound hypertension.” As noted by the researchers, lifestyle modifications play an important role in reducing the need for medications and perhaps facilitating their with- drawal.  Previous studies have demonstrated that lifestyle interventions can double the success rate of maintaining a normal blood pressure after withdrawal of medication.  Weight loss and sodium restriction were important predictors of suc- cess in this study.   Reducing alcohol intake and increasing physical activity have also been shown to be beneficial. This article concludes that appropriate individuals for consideration of withdrawal of antihypertensive medica- tion are those people who are on only one medication and have been well con- trolled for a long period of time.  It is important to never stop taking medica- tions without the consent of a doctor. High blood pressure, also known as hypertension, is a major risk factor for cardio- vascular disease.  This silent killer frequently has no symptoms until a devastat- ing event such as stroke or heart attack occurs. Approximately 10% of peo- ple in Western countries take medication to control their blood pressure. If sim- ple steps are taken to reduce the need for drug therapy, perhaps some med- ications may not be required.  In a recently pub- lished article in the American Journal of Hypertension, Dr. Mark Nelson analyzed the results of 12 studies that examined the effects of with- drawal of high blood pres- sure medications over at least a one-year period.  He and his colleagues identified several predictors of suc- cessful withdrawal of med- ication with continued main- tenance of normal blood pressure. The risk of return to elevated levels was greatest in the Lifestyle Changes May Reduce Your Need for Antihypertensive Medications. Those factors most associated with successful withdrawal of high blood pressure medications included: • Mild blood pressure elevation before drug therapy was    begun • Few drugs required for effective treatment (preferably one) • Lifestyle intervention In the present study, 42% of individuals were able to main- tain normal blood pressure for one year following the supervised withdrawal of medication. Lifestyle changes which may reduce your need for blood pressure medications include: • Losing weight • Decreasing sodium intake • Reducing alcohol consumption • Increasing physical activity Title: A Systematic Review of Predictors of Maintenance of Normotension After Withdrawal of Antihypertensive Drugs Authors: Mark Nelson, Christopher Reid, Henry Krum and John McNeil Source: American Journal of Hypertension. 2001;14:98- 105

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