Guanethidine-Resistant Hypertension
Abstract
Resistance of hypertensive patients to large doses of guanethidine is seldom due to defective absorption of the drug, since the existence of adrenergic blockade can be demonstrated in these cases.
The effect on the blood pressure of intravenous phenoxybenzamine and norepinephrine, respectively, has been compared in groups of hypertensive patients resistant and responsive to guanethidine.
As both the hypotensive action of intravenous phenoxybenzamine, a peripheral antagonist of norepinephrine, and the pressor effect of norepinephrine infusion were more marked in patients resistant to guanethidine it seems likely that the maintenance of high blood pressure in these cases is due to enhanced sensitivity of the arterioles to endogenous norepinephrine. To combat this effect the therapeutic use of phenoxybenzamine appeared logical.
Phenoxybenzamine taken by mouth has been found by itself to be an unsatisfactory hypotensive agent but when used in combination with guanethidine has proved highly effective. The blood pressure of 13 out of 16 hypertensive cases previously resistant to guanethidine in high dosage has been controlled for periods of from 3 to 30 months after the addition of phenoxybenzamine.
When used in combination with guanethidine, phenoxybenzamine caused no side effects.
Formats available
You can view the full content in the following formats:
Information & Authors
Information
Published In
Copyright
© 1968 American Heart Association, Inc.
History
Published online: 1 September 1968
Published in print: September 1968
Keywords
Authors
Metrics & Citations
Metrics
Citations
Download Citations
If you have the appropriate software installed, you can download article citation data to the citation manager of your choice. Select your manager software from the list below and click Download.
- Resistant Hypertension: A Real Entity or a Phantom Diagnosis?, The Journal of Clinical Hypertension, 17, 8, (578-579), (2015).https://doi.org/10.1111/jch.12565
- A comparison and an investigation of a potential synergistic effect of labetalol and bethanidine in patients with mild hypertension., British Journal of Clinical Pharmacology, 8, S2, (2012).https://doi.org/10.1111/j.1365-2125.1979.tb04778.x
- Depressants of peripheral sympathetic nerve function, Pharmacology of Antihypertensive Drugs, (194-238), (1984).https://doi.org/10.1016/B978-0-444-90313-6.50013-7
- Blood Pressure Control in Chronic Dialysis Patients, Replacement of Renal Function by Dialysis, (575-587), (1983).https://doi.org/10.1007/978-94-009-6768-7_28
- Specific antibodies against the irreversible α-adrenergic antagonist, phenoxybenzamine, Biochemical Pharmacology, 30, 12, (1685-1692), (1981).https://doi.org/10.1016/0006-2952(81)90397-X
- Toxic Effects of Adrenergic Nerve-End Inhibitors, Neural-Transmitter Depleting Agents and False Transmitters, Adrenergic Activators and Inhibitors, (505-558), (1981).https://doi.org/10.1007/978-3-642-67584-3_13
- Blood Pressure Control in Chronic Dialysis Patients, Replacement of Renal Function by Dialysis, (504-518), (1979).https://doi.org/10.1007/978-94-009-9327-3_27
- Exertional hypotension due to postganglionic sympathetic blocking drugs, Postgraduate Medical Journal, 52, 610, (487-491), (1976).https://doi.org/10.1136/pgmj.52.610.487
- Guanethidine, New England Journal of Medicine, 295, 19, (1053-1057), (1976).https://doi.org/10.1056/NEJM197611042951906
- Time-course effects of oral guanethidine administration on cardiovascular and autonomic effects on dogs, European Journal of Pharmacology, 36, 1, (21-32), (1976).https://doi.org/10.1016/0014-2999(76)90252-1
- See more
Loading...
View Options
Login options
Check if you have access through your login credentials or your institution to get full access on this article.
Personal login Institutional LoginPurchase Options
Purchase this article to access the full text.
eLetters(0)
eLetters should relate to an article recently published in the journal and are not a forum for providing unpublished data. Comments are reviewed for appropriate use of tone and language. Comments are not peer-reviewed. Acceptable comments are posted to the journal website only. Comments are not published in an issue and are not indexed in PubMed. Comments should be no longer than 500 words and will only be posted online. References are limited to 10. Authors of the article cited in the comment will be invited to reply, as appropriate.
Comments and feedback on AHA/ASA Scientific Statements and Guidelines should be directed to the AHA/ASA Manuscript Oversight Committee via its Correspondence page.