Related Experiment Videos
Safety aspects of long-term antihypertensive therapy (10 years) with clonidine
L Ferder1, F Inserra, F Medina
1Department of Pharmacology Faculty of Medicine, University of Buenos Aires, Argentina.
Insights
Clonidine effectively lowered blood pressure in patients with essential hypertension over 10 years. Long-term therapy demonstrated sustained efficacy with minimal, manageable side effects and improvements in related conditions.
Area of Science:
- Cardiology
- Pharmacology
Background:
- Essential hypertension is a widespread cardiovascular condition requiring long-term management.
- Effective and safe antihypertensive medications are crucial for preventing complications.
Purpose of the Study:
- To evaluate the long-term efficacy and safety of clonidine in treating essential hypertension over a 10-year period.
- To assess the impact of clonidine on blood pressure, side effects, and related health outcomes.
Main Methods:
- A 10-year study involving 128 patients (40 +/- 9 years) with essential hypertension (W.H.O. I and II).
- Treatment with clonidine (0.150–1,200 mg twice daily), with 42 patients also receiving hydrochlorothiazide (HCTZ).
- Monitoring of blood pressure, side effects, renal and liver function, electrolytes, lipids, retinopathy, and electrocardiograms (ECG).
Main Results:
- Significant reduction in mean blood pressure from 169/107 mm Hg to 145/90 mm Hg (p < 0.001).
- Initial side effects included drowsiness (28%), dry mouth (35%), and constipation (13%), with most resolving or persisting at low rates long-term.
- Treatment discontinuation due to side effects was low (3.34%), occurring within the first 6 months.
- No adverse changes in renal or liver function, electrolytes, or lipids were observed.
- Improvement in retinopathy and ECG findings in patients with left ventricular hypertrophy (LVH).
Conclusions:
- Clonidine provides sustained and effective blood pressure control for essential hypertension over 10 years.
- The medication is generally well-tolerated, with most side effects being transient and manageable.
- Clonidine therapy can lead to positive outcomes in associated conditions like retinopathy and LVH.
Abstract:
We have treated 128 patients aged 40 +/- 9 years (60 males and 68 females), all with essential hypertension (W.H.O. I and II), over a period of 10 yr. The treatment was performed with clonidine at a dose that ranged from 0.150 to 1,200 mg (twice daily). Forty-two patients also received a diuretic (HCTZ 25 mg daily). Mean blood pressure decreased significantly from 169 +/- 10 mm Hg systolic, 107 +/- 3 diastolic to 145 +/- 6 mm Hg (p less than 0.001) 90 +/- 3 mm Hg diastolic (p less than 0.001). Side effects occurred during the first month. These were drowsiness 28%, dry mouth 35%, constipation 13%, dizziness 9%, postural hypotension 2%, and male impotence 3.3% (2/60). Side effects still present after 120 months of treatment were drowsiness 11.7%, dry mouth 26.6%, constipation 14.1%, dizziness 4.7%, and male impotence 1.7% (1/59). The number of patients who discontinued treatment resulting from side effects were 3.34%, all of them within the first 6 months. There were no changes in renal or liver function or in serum electrolytes or lipids. Retinopathy improved in most patients. Electrocardiogram (ECG) improved in 45 patients with LVH. It is concluded that clonidine provided sustained blood pressure control with minimum side effects during 10-year therapy for hypertension.