What Are the Causes of Rebound Hypertension?

Hypertension is one of the most common medical conditions around the world. It is an important public health problem, with high mortality and morbidity. Rebound hypertension occurs after the sudden withdrawal of medications taken to control high blood pressure.

Background Physiology

• Blood pressure control, even in a healthy individual, is a complicated process, because it results from a combination of cardiac output and peripheral vascular resistance (PVR), each of which can be influenced by a variety of factors.

Abnormal Physiology

• Abnormal increase in blood pressure can be caused by: increase in volume of the blood; electrolyte disturbances; kidney problems, metabolic syndrome, eclampsia (normal condition in pregnancy) and pheochromocytoma, a tumor that secretes the hormone epinepherine.

Selecting Medications

• Lists of approved drugs given to treat the condition are lengthy, and clinical studies constantly enable new antihypertensive medications to be included. The decision on which drugs to prescribe depends on the type and severity of a patient's hypertensive condition.

Common Drugs

• Categories of drugs prescribed for hypertension include: calcium channel blockers, which help blood vessels to dilate; inhibitors of angiotensin converting enzyme (ACE inhibitors), and thiazide-type diuretics. Other categories are angiotensin II receptor blockers (ARBs) and beta-blockers.

Avoiding Rebound Hypertension

• When rebound hypertension occurs, it is often considered a medical emergency that requires prompt attention to avoid further complications. If a lower dosage is recommended, plan to gradually reduce the medication over a period of time.