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Antihypertensive effect of clonidine and salt depletion in severe hypertension: Clinical and haemodynamic study

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The antihypertensive effect of clonidine has been studied in ten patients with severe hypertension, who had first been salt depleted by diuretics (5% weight loss produced by spironolactone and furosemide). The mean arterial pressure fell from 155±2 mm Hg to 98±3 mm Hg with average doses of clonidine of 150 to 750 µg/day. There was a reversible exacerbation of renal failure which had to be accepted in order to achieve normal arterial pressure. Despite salt depletion, the stroke index remained unchanged in the supine position, while the cardiac index fell from 3010±214 to 2333±164 ml/min/m2 (P<0.01). In 45° head-up tilting there was only a 4% decrease in mean arterial pressure despite a large fall in the cardiac index (27%); the total peripheral resistance (27%) and heart rate (33%) rose considerably from their control values. During exercise, the more conventional change in total peripheral resistance and fall in ventricular work showed the beneficial effect produced by this treatment.

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Safar, M., Sobel, A. & Milliez, P. Antihypertensive effect of clonidine and salt depletion in severe hypertension: Clinical and haemodynamic study. Eur J Clin Pharmacol 5, 203–209 (1973).

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Key words

  • Accelerated hypertension
  • clonidine
  • cardiac output
  • salt depletion