Abstract
Experience with three patients cared for by one group over a 12-month period suggested to us that rebound hypertension with hypertensive crisis in the setting of clonidine withdrawal was not a rare event and, indeed, compelled us to report our observations. The hypothesis that a surge of increased sympathetic activity associated with clonidine withdrawal in the presence of β-adrenergic blockade would result in unopposed, potentiated α-adrenergic vasoconstriction is well reasoned, and as we mentioned in our article, it has been suggested by other authors.1,2 We agree that careful thought must be given to the discontinuation of antihypertensive therapy with clonidine, in combination or alone. This appears to us to be particularly important in persons with renovascular or high-renin essential hypertension.
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