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Richard H. Thurm, MD; William M. Smith, MD

JAMA. 1967;201(5):301-304.

Abstract
Approximately ten years ago, it was shown that when hypertension was induced in dogs by a Goldblatt clamp, the carotid sinus was reset, becoming insensitive to the elevated pressure. Is it then conceivable that antihypertensive therapy may result in a lowering of this "barostat" setting, permitting discontinuation of therapy? The US Public Health Service Cooperative Study of Hypertension provided an opportunity to evaluate this question. Sixty-nine "responders" to various antihypertensive agents had their medications discontinued after an average response period of more than two years, with uninterrupted recordings of the pressure at home. Twenty-five patients remained responders (average diastolic pressure below 90 mm Hg) for at least five months. Of this group, nine required reinstitution of therapy, 5 to 24 months later, due to the gradual rise of their diastolic pressures.

Author Affiliations
From the US Public Health Service Hospital, Boston.

Footnotes
Read in part before the US Public Health Service Clinical Society and Commissioned Officers' Assoc, Baltimore, May 13, 1966, and the Regional Meeting of the American College of Physicians, Montreal, Nov 12, 1966.

Reprint requests to 77 Warren St, Boston 02135 (Dr. Thurm).

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