Hypertensive crisis associated with nifedipine withdrawal.

A 71-year-old hypertensive patient experienced a severe hypertensive crisis. His blood pressure was 300/200 mm Hg three days after nifedipine therapy was discontinued. He had been taking nifedipine together with methyldopa. During five months on the combined treatment, his blood pressure had not risen higher than 170/100 mm Hg. A severe hypertensive crisis following abrupt nifedipine withdrawal has not been previously reported, to our knowledge. We recommend that caution be used when abrupt cessation of nifedipine therapy is considered in the treatment of hypertension.