Clinical pilot study with guanfacine alone alone or in combination with a diuretic

摘要

In 221 patients with essential or renal hypertension, marked reductions in systolic and diastolic blood pressures were obtained with guanfacine alone or in combination with a diuretic.Starting from 0.5 mg daily, the doage was gradually increased up to 4.0 mg daily, the average maintenance dose being 2.0 mg daily, taken twice daily. Duration of treatment was 8 weeks or more. Guanfacine showed a rapid onset of action and significant antihypertensive effect on both systolic and diastolic blood pressures, which continued to fall even after the 8-week treatment period.Mean blood pressure was reduced from 178.8 ± 1.6/105.7 ± 1.1 mmHg to 154.7 ± 2.0/92.6 ± 1.0 mmHg with monotherapy, and from 180.44 ± 1.8/104.2 ± 1.0 mmHg to 158.2 ± 2.61/93.5 ± 1.31 mmHg with combined therapy.The response rate was 63.1% with monotherapy and 60.6% with combined therapy, if we regard a reduction of over 20/10 mmHg as a response. As side-effects, dry mouth was observed in 61 out of 221 cases (27.6%), sleepiness in 24 (10.9%), headache in 13 (5.9%), tiredness in 13 (5.9%), dizziness in 10 (4.5%), and orthostatic disturbances in 5 (2.3%).Six patients discontinued the treatment due to dry mouth and dizziness. Laboratory parameters remained within the normal range.