A dose-titration trial of guanadrel as step-two therapy in essential hypertension.

Abstract

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.

• Authors: A Oren, H H Rotmensch, P H Vlasses, L J Riley Jr, J R Koplin, V Latini, R K Ferguson
• Journal: Journal of clinical pharmacology (J Clin Pharmacol) 1985 Jul-Aug Vol. 25 Issue 5 Pg. 343-6 ISSN: 0091-2700 [Print] England
• PMID: 4031111 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Antihypertensive Agents
• Guanidines
• Hydrochlorothiazide
• guanadrel

Topics

• Adult
• Antihypertensive Agents (adverse effects, therapeutic use)
• Drug Administration Schedule
• Female
• Guanidines (adverse effects, therapeutic use)
• Humans
• Hydrochlorothiazide (therapeutic use)
• Hypertension (drug therapy, physiopathology)
• Male
• Middle Aged