Is a hypertensive always a hypertensive?

Forty two patients of uncomplicated essential hypertension with well controlled and stable blood pressure for the last six months have been followed up for 2 years after withdrawal of therapy. Drug therapy was reinstituted if they became hypertensive again. Thirty four (89.9%) and 33 patients remained normotensive at 4 and 8 weeks respectively. At the end of 6 months, 26 (61.9%) patients were drug free, 9 (21.4%) were back on therapy and 7 (16.5%) were lost to follow up. At the end of one year, 18 (42.8%) were drug free, 14 (33.3%) were on drugs and 10 (23.8%) had dropped out. At the end of 2 years, the figures were 14 (drug free), 15 (on drugs) and 13 (drop-outs). No cardiovascular or any other complication was recorded during the period. These observations suggest that there may be a subgroup of mild or moderate hypertensives in whom it may be possible to withdraw therapy under observation. However, there is a risk of substantial drop out rate possibly under a false sense of security. Considering the large number of hypertensives in our country and the world over, its economic and therapeutic implications are obvious.