The relative benefits and risks of
reserpine and
guanethidine were compared in patients with
thiazide-treated mild to moderate
hypertension (diastolic pressure 95-115 mm Hg). Forty-nine ambulant patients )30 men, 19 women) were treated throughout the study with
hydrochlorothiazide, 50 mg/day. In this double blind crossover study each
drug was added in graded increments until a predetermined therapeutic response was obtained, blood pressure measurements and side effect scores were evaluated biweekly. Major conclusions of the study were: 1)
guanethidine, as well as
reserpine, will reduce mild to moderate blood pressures to normal; 2) in most cases, side effects which did occur while taking
guanethidine or
reserpine were well tolerated and neither
drug was clearly superior. Side effects associated with larger doses of
guanethidine employed in severe
hypertension were absent or only slightly bothersome. Thus,
guanethidine apppears to have a good benefit-to-risk ratio in the
therapy of mild to moderate
hypertension and offers a number of advantages over drugs commonly used in this syndrome. This study refutes the common belief that
guanethidine must be reserved only for the treatment of more severe degrees of
hypertension.