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Oral Clonidine for Rapid Control of Accelerated Hypertension
Author(s) -
Marks Allan D.,
Adlin E. Victor,
Channick Bertram J.
Publication year - 1987
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.1552-4604.1987.tb02183.x
Subject(s) - clonidine , supine position , medicine , blood pressure , anesthesia , ambulatory , diuretic , adverse effect , diastole , heart rate , surgery
Thirty emergency‐room patients, 15 men and 15 women, from 27 to 64 years old with diastolic blood pressures (DBP) >115 mm Hg, were admitted to an open‐label, oral loading trial of clonidine. At this time, their supine mean arterial pressures (MAP) averaged 150 ± 2 mm Hg. An initial clonidine dose of 0.1 to 0.2 mg was to be followed every hour by another 0.1 mg until the DBP had been lowered to a level allowing treatment to be continued on an ambulatory basis or until a total of 0.5 mg had been given. A satisfactory response—defined as a reduction of the supine DBP to 105 mm Hg or lower if the baseline was between 115 and 135 mm Hg, or reduction of a baseline DBP >135 mm Hg by at least 30 mm Hg—was achieved in all but one of the patients in an average of 118 minutes; the mean dose required was 0.26 mg. The mean reduction from the baseline MAP was 23.1 ± 0.9%. Drug‐related adverse experiences comprised drowsiness and dry mouth in 13 patients. Thereafter, 28 of the patients were chronically treated with clonidine for an average of 73 days. In 24 patients treated for at least 80 days, the daily clonidine dose averaged 0.375 mg. All the patients required concurrent diuretic therapy. A satisfactory response (as defined above) to this maintenance treatment was shown by 85% of the patients, and full blood‐pressure control (supine DBP <95 mm Hg) was attained in 78%. The mean decreases from the baseline systolic and diastolic readings (taken before the acute treatment phase) amounted to 28.6% ± 2.5% and 19.8% ± 1.3%, respectively. Side effects were essentially the same as during the oral loading phase.