Effects of low-dose antihypertensive therapy in elderly patients with predominant systolic hypertension.
Patients over 60 years of age (M = 70 years) with the predominant systolic form of essential hypertension (systolic blood pressure greater than 160 mm Hg; diastolic blood pressure less than 100 mm Hg) were treated with a combination of low doses of the diuretic chlorthalidone and the centrally-acting sympatholytic agent clonidine. In this randomized double-blind study, patients received either active treatment (n = 14) or placebo (n = 16). Baseline systolic blood pressure in the treatment group averaged 172 mm Hg and was controlled (fall in systolic blood pressure to less than 140 mm Hg or by at least 10%) in 13 of the 14 patients; in eight patients, control was achieved with a single daily dose (given at night) of the clonidine (.1 mg)-chlorthalidone (15 mg) combination. The active drug was significantly superior to placebo in decreasing systolic blood pressure. Changes measured in the standing position did not differ from those in the supine position. Side effects were mild and transient for both the placebo and the treatment groups. Low-dose combination therapy appears to be a highly effective approach for the management of older patients with predominant systolic hypertension of mild-to-moderate degree.
D000368:Aged; D001794:Blood Pressure / Q000187:drug effects; D002752:Chlorthalidone / Q000627:therapeutic use*; D003000:Clonidine / Q000627:therapeutic use*; D004338:Drug Combinations; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D011187:Posture; D011897:Random Allocation
D004338:Drug Combinations; D003000:Clonidine; D002752:Chlorthalidone