Studies on the Control of Hypertension

Because doses of antihypertensive agents necessary to control human arterial hypertension at relatively normotensive levels were observed to decrease with time, records of all patients in our series receiving oral hexamethonium chloride and hydralazine (but no other drugs) were analyzed (114 cases). After two years of therapy, those patients maintaining average diastolic pressures below 100 mm. Hg were found to require considerably less methonium ion while those unable or unwilling to control their pressures to this degree needed approximately their initial doses. Further decreases in drug requirements for the well-controlled group occurred after three years. Ten were able to discontinue all medication eventually and nine others needed only smaller doses of hydralazine; in these reversal of secondary changes was sometimes observed. Prolonged, continuous and adequate drug therapy is apparently associated with a change in the basic process producing hypertension.