[Estulic in the long-term treatment of hypertension]

Estulic (guanfacine), a new centrally acting antihypertensive agent derived from guanidine, was administered to 13 patients with established essential hypertension. Therapeutic effect and safety were evaluated in all patients during the first year. Blood pressure normalization was elicited in 6 patients and a good therapeutic response in 5. Two patients did not respond to the monotherapy. Dryness of the mouth was observed in 11 patients during the first year and tiredness in 4. At the end of the first year, 3 patients out of 7 who completed the 1-year treatment still complained of dry mouth. Five patients continued for a second year of treatment. In all of them the blood pressure was normalized and only one patient suffered from dryness of the mouth. Estulic was usually given once daily in the evening; in some patients it was given twice daily. At the end of the first year, doses between 2 and 7 mg were used (mean 3.4 mg); during the second year 2 mg/day was administered to 2 patients, 3 mg/day to 2 patients and 5 mg to 1 patient. No impairment of laboratory values was seen during long-term treatment. In one patient with renal insufficiency the treatment had to be discontinued owing to deterioration of the underlying disease. After withdrawal of the drug, no rebound hypertension was observed.