Authors' response

摘要

We thank Rigter and Koffeman for their comments on our paper. The aim of this study was to explore the feasibility and consequences of a re-evaluation programme for patients without target organ damage who were treated for hypertension and/or hypercholesterolemia in general practices. We have shown that stopping medication of itself can be assumed to be safe, as no important adverse effects took place during the 6-month follow-up. As stated in the discussion section of our paper, we agree that until now it is not known what the morbidity and mortality will be in the discontinuing versus the continuing group in the next 10 years. However, if pretreatment levels of blood pressure and cholesterol were unknown, we have chosen to assume high levels of systolic blood pressure (180 mmHg] and total cholesterol to HDL-cholesterol ratio [8.0] to minimise the number of underestimated levels. Therefore, even if the blood pressure or lipid profile would change during follow-up, it. would not alter the estimated low risk of cardiovascular mortality. Consequently, presenting data on these variables would thus have no additional value. Further, as also mentioned in the discussion section, the new guidelines on cardiovascular risk management are based on extensive clinical evidence. Therefore, we assume that stopping superfluous medication in patients with a low risk of cardiovascular mortality will not, of itself, increase mortality rate.