Abstract：
An integral component of the practice of medicine is focused on the initiation of medications, based on clinical practice guidelines and underlying trial evidence, which usually test the addition of novel medications intended for life-long use in short-term clinical trials. Much less attention is given to the question of medication discontinuation, especially after a lengthy period of treatment, during which patients age gets older and diseases may either progress or new diseases may emerge. Given the paucity of data, clinical practice guidelines offer little to no guidance on when and how to deprescribe cardiovascular medications. Such decisions are often left to the discretion of clinicians, who, together with their patients, express concern of potential adverse effects of medication discontinuation. Even in the absence of adverse effects, the continuation of medications without any proven effect may cause harm due to drug-drug interactions, the emergence of polypharmacy, and additional preventable spending to already strained health systems. Herein, several cardiovascular medications or medication classes are discussed that in the opinion of this author group should generally be discontinued, either for the prevention of potential harm, for a lack of benefit, or for the availability of better alternatives.
摘要：
医学实践的一个组成部分是集中在药物的开始，根据临床实践指南和潜在的试验证据，通常在短期临床试验中测试用于终身使用的新型药物的添加。对停药问题的关注要少得多，尤其是经过长时间的治疗，在此期间，患者年龄变大，疾病可能进展或新的疾病可能出现。鉴于数据的匮乏,临床实践指南对何时以及如何停用心血管药物几乎没有提供指导。这样的决定通常由临床医生自行决定，谁,和他们的病人一起，对停药的潜在不良反应表示关注。即使没有不良影响，没有任何已证实的效果的药物继续用药可能会由于药物-药物相互作用而造成伤害，多药房的出现，以及对已经紧张的卫生系统的额外可预防支出。在这里，讨论了几种心血管药物或药物类别，作者小组认为通常应停用，无论是为了防止潜在的伤害，由于缺乏利益，或者是为了获得更好的替代品。
