Adrenolytic and Vasodilator Therapy

The 1974 document reviewed the use of adrenolytic and vasodilator drugs for treating hypertension, noting the limitations of existing drugs like guanethidine, methyldopa, and hydralazine, such as unresponsiveness, side effects, and potential lupus syndrome. It introduced clonidine, which avoids postural hypotension but may cause drowsiness, and vasodilators like diazoxide and sodium nitroprusside, which are effective but can lead to compensatory changes and sodium retention. Minoxidil was recognized for its efficacy but had side effects like hirsutism and cardiac issues in animal studies, while bupicomide was a new, less toxic vasodilator. Prazosin, a new antihypertensive agent, was found to be as effective as methyldopa in a double-blind study of 35 patients and well-tolerated in combination with polythiazide in a study of 20 patients, though it caused headaches and palpitations. The document suggested that despite their limitations, these drugs were crucial for treating severe hypertension and anticipated prazosin as a useful alternative for moderate diastolic hypertension.