Safety and efficacy of guanabenz in hypertensive patients with moderate renal insufficiency

Eight hypertensive patients with moderate renal insufficiency were treated with gradually increasing oral doses of guanabenz acetate to a maximum dose of 8 mg BID. Patients' medications were titrated over 8 weeks. Once blood pressure control was achieved (seated diastolic blood pressure, 90 mmHg, or decrease of 10 mmHg from baseline values), drug dosages were maintained for up to a 12-week total treatment phase. Patients had significant reductions of blood pressure during treatment with guanabenz as compared to that during pretreatment levels. No changes in body weight or creatinine clearance were evident, as compared to baseline values. Our data suggest that guanabenz, in relatively small doses, can be used as safe and effective monotherapy of essential hypertension in patients with moderate renal insufficiency.