These data demonstrate that in normal subjects angiotensin II is 10 times as potent as norepinephrine, which it resembles hemodynamically. An increase in the systolic pressure is associated with significant increase in diastolic pressure, increase in venous pressure, decrease in heart rate, slight decrease in cardiac output with striking increase in total peripheral resistance, decrease in renal blood flow, decreased glomerular filtration rate, increase in filtration fraction, arid slight decrease in urinary volume. Preliminary studies of patients in shock suggest that angiotensin II is two or three times as potent as norepinephrine. Continuous administration is not associated with the development of resistance or tachyphylaxis, nor does sloughing of tissues occur when there is leakage outside the vein.

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One hundred nine patients with moderately severe hypertension and 12 patients with severe hypertension received the combination of 50 mg. of chlorthalidone plus 0.25 mg. of reserpine combined in a single tablet (Regroton) administered once daily for an average duration of 2 years. The ease of administration (one tablet daily), the effectiveness (78-per cent good response), the lack of development of drug resistance over a 2-year period, and the small incidence of side effects would seem to make the combination of 50 mg. of chlorthalidone plus 0.25 mg. of reserpine the ideal treatment for most patients with hypertension. If a more rapid reduction in arterial pressure is indicated, as in patients with severe hypertension, or if a satisfactory therapeutic response has not been observed in 3 to 4 months in patients with moderately severe hypertension, suboptimal doses of other antihypertensive agents may be added.

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