Randomized, double-blind comparison of transdermal clonidine with oral propranolol

The antihypertensive effect of transdermal clonidine (TC) vs. oral propranolol (OP) was evaluated in 32 patients with mild essential hypertension (mean BP 150/95 mm Hg). The protocol consisted of a 4-week pretreatment washout period, a 2- to 6-week titration, a 4-week maintenance phase, and a 1-week postwashout phase. BP control (diastolic BP less than 90 mm Hg) was achieved in 15 out of 17 transdermal patients, and in 12 out of 14 propranolol subjects. Comparable decreases in systolic/diastolic BP were noted (-19/15 mm Hg for TC vs. -24/13 mm Hg for OP). No rebound symptoms were reported after sudden cessation of the transdermal system during the post-treatment washout. Side effects were recorded in 3 out of 17 TC patients, and in 3 out of 15 OP patients with 1 OP dropout. A mild transient erythematous rash developed in 2 TC and 2 OP (placebo patch) patients. We conclude that the safety and efficacy of TC is comparable to OP for monotherapy in mild hypertensives.