Premium
A Dose‐Titration Trial of Guanadrel as Step‐Two Therapy in Essential Hypertension
Author(s) -
Oren Arie,
Rotmensch Heschi H.,
Vlasses Peter H.,
Riley Louis J.,
Koplin Janice R.,
Latini Vincent,
Ferguson Roger K.
Publication year - 1985
Publication title -
the journal of clinical pharmacology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.92
H-Index - 116
eISSN - 1552-4604
pISSN - 0091-2700
DOI - 10.1002/j.1552-4604.1985.tb02852.x
Subject(s) - medicine , titration , pharmacology , essential hypertension , intensive care medicine , chemistry , blood pressure , inorganic chemistry
The efficacy and safety of low‐dose guanadrel sulfate were evaluated in 20 patients with essential hypertension based on seated diastolic blood pressures (SDBP) ranging from 95 to 115 mm Hg despite a trial dosage of hydrochlorothiazide 50 mg/d for up to five weeks. These patients had been resistant to, or intolerant of, one or more step‐two antihypertensive drugs in the past (i.e., methyldopa, beta‐adrenergic blocking agents, clonidine, or prazosin). The majority of patients demonstrated a satisfactory response (SDBP 95 mm Hg or reduction in SDBP of 10 mm Hg) to guanadrel. Nine patients responded at a low dosage, 10 to 20 mg/d and remained free from adverse effects throughout the study (up to 12 weeks of treatment). Of the remaining 11 patients titrated to higher dosages of guanadrel (30 to 60 mg/d), three had no discernible response while six developed adverse effects. The results of the study suggest that guanadrel has an acceptable benefit‐to‐risk ratio only when used in low dosages (10 to 30 mg/d) and may be successfully employed as step‐two antihypertensive therapy in patients resistant to, or intolerant of, other step‐two agents.