Close Clinical Observation Minimizes the Complications of Beta-Blocker Withdrawal

Abstract

Spanish

French

OBJECTIVE:

To determine whether beta-blocker withdrawal under close medical supervision poses undue risks.

DESIGN:

Retrospective case review. Data extracted from previous study.

SUBJECTS:

114 hypertensive subjects tapered from beta-blocker therapy. Subjects were a subset of patients originally studied for blood pressure medication withdrawal and biofeedback training.

MAIN OUTCOME MEASURES:

Frequency of symptoms and adverse effects reported by subjects during medication taper to the study nurse.

RESULTS:

Symptoms were no more likely to occur with beta-blocker withdrawal than with withdrawal of other types of antihypertensive medications. Most adverse effects were classified as minor. Two subjects experienced major symptoms. One subject required reinstitution of beta-blockers for palpitations, and another exhibited angina upon beta-blocker withdrawal.

CONCLUSIONS:

In well-screened patients under careful monitoring, withdrawal from beta-blockers appears to present a small, manageable risk.

Get full access to this article

View all access options for this article.

References

Frishman

. Beta-adrenergic blocker withdrawal. Am J Cardiol 1987; 59 (suppl):26F–32F.

Houston

Hodge

. Beta-adrenergic blocker withdrawal syndromes in hypertension and other cardiovascular diseases. Am Heart J 1988; 116: 515–23.

Hart

Anderson

. Withdrawal syndromes and the cessation of antihypertensive therapy. Arch Intern Med 1981; 141: 1125–7.

Psaty

Koepsell

Wagner

LoGerfo

Inui

. The relative risk of incident coronary heart disease associated with recently stopping the use of beta-blockers. JAMA 1990; 263: 1653–7.

Blanchard

McCoy

Musso

Gerardi

Pallmeyer

Gerardi

A controlled comparison of thermal biofeedback and relaxation training in the treatment of essential hypertension: Short-term and long-term outcome. Behav Ther 1986; 17: 563–79.

Blanchard

Cornish

Wittrock

Fahrion

. Subjective experiences associated with thermal biofeedback treatment of hypertension. Biofeedback Self Regul 1990; 15: 145–9.

Blanchard

Kramelashvili

McCoy

Aivazyan

McCaffrey

Salenko

The USA-USSR collaborative cross-cultural comparison of autogenic training and thermal biofeedback in the treatment of mild hypertension. Health Psychol 1988; 7 (suppl):175–92.

Blanchard

McCoy

Andrasik

Acerra

Pallmeyer

Gerardi

Preliminary results from a controlled evaluation of thermal biofeedback as a treatment for essential hypertension. Biofeedback Self Regul 1984; 9: 471–95.

Blanchard

Eisele

Gordan

Cornish

Gilmore

. Thermal biofeedback as a substitute for sympatholytic medication in moderate hypertensives: a failure to replicate. Paper presented at the 24th Annual Meeting of the Association for Applied Psychophysiology and Biofeedback, Los Angeles, CA, March, 1993.