Clonidine in the Treatment of Severe Hypertension

Raftos, John; Bauer, G. E.; Lewis, Ronald G.; Stokes, Gordon S.; Mitchell, Anne; Young, Alan A.; MacLachlan, Ida F.

doi:10.5694/j.1326-5377.1973.tb110692.x

Cited by 44 publications

(4 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In conclusion, despite being one of the most common medications dialysis patients are prescribed, no data currently support the long-term use of clonidine in maintenance HD patients, and a significant side-effect profile exists which may ultimately lead to worse outcomes. Fluid removal strategies and oth-er antihypertensives with strong evidence such as ACEIs/ ARBs [22][23][24] and carvedilol [33] should be used over clonidine for long-term BP control in the HD population.…”

Section: Discussionmentioning

confidence: 99%

“…ACEIs/ARBs ultimately work through the renin and angiotensin pathway which not only lowers BP but also helps to prevent salt and thus water retention longterm. The mortality benefit of these medications is well researched [22][23][24], but the mortality benefit of clonidine which works through a different mechanism to block sympathetic outflow and cause peripheral vasodilation still needs to be investigated. In conclusion, despite being one of the most common medications dialysis patients are prescribed, no data currently support the long-term use of clonidine in maintenance HD patients, and a significant side-effect profile exists which may ultimately lead to worse outcomes.…”

Section: Discussionmentioning

confidence: 99%

“…Clinical research on clonidine prior to the year 2000 primarily includes small pre/post cohort studies that have an even smaller subset of patients with unspecified renal disease. These studies do not characterize stages of kidney disease, the etiologies, or the outcome variables for the subgroup of patients with kidney disease [3, 20‒22]. For example, MacDougall et al [23] included 5 patients with renal disease within his cohort of 28 patients, but the stages of renal disease and the outcomes were not reported for the subset of patients.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

The Safety and Efficacy of Clonidine in Hemodialysis Patients: A Systematic Review and Meta-Analysis

Derk

Barton

An³

et al. 2022

Pharmacology

View full text Add to dashboard Cite

Background: Clonidine is a frequently prescribed long-term antihypertensive medication in hemodialysis (HD) patients in the USA, but its safety and efficacy has not been clearly established in the HD population. Objective: To evaluate, we conducted a systematic review and meta-analysis on the safety and efficacy of clonidine in HD patients. Methods: Keyword search of “clonidine” and “dialysis” was conducted through April 2021 in PubMed, Cochrane Library, Web of Science, Scopus, and ClinicalTrials.gov databases. Inclusion criteria were as follows – study design: randomized controlled trials, cohort studies, prospective studies, retrospective studies, or case series; subjects: adult HD patients; main outcome: blood pressure (BP) and safety; language: English; and article type: peer-reviewed publications. Studies that examined the effects of clonidine in populations other than adult HD patients were excluded. Meta-analysis was performed on BP reduction outcomes. Results: Eight studies met the inclusion criteria for the systematic review, including prospective pre-post studies (2), double-blind controlled trial (1), single-blinded placebo-controlled trial (1), crossover open-label clinical trial (1), retrospective analysis (1), and case report series (2). Three studies included in the meta-analysis ranged from 2 to 12 weeks duration, with a collective sample size of 24 (ages 12–77 years). Risk of bias, assessed using the ROBINS-1 tool, was high for all included studies. Significant adverse effects reported included hypotension, light-headedness, drowsiness, dry mouth, rebound hypertension, and contact dermatitis from patch application. Short-term clonidine use was associated with significant improvement in systolic BP (pooled effect: −12.985 mm Hg, 95% CI [−7.878, −18.092], p < 0.001), while changes in diastolic BP were not statistically significant (−11.119 mm Hg, 95% CI [−22.725, 0.487], p = 0.060). No data currently support the long-term efficacy of clonidine in HD patients. This study was unfunded and was developed using PRISMA guidelines and registered on PROSPERO (CRD42018112042). Conclusions: There is no evidence supporting the long-term use of clonidine in the HD population and a significant side-effect profile. There is low-quality evidence demonstrating the efficacy of clonidine in lowering BP in HD patients in short-term use, but significant safety concerns remain. Fluid removal strategies and other antihypertensives should be used over clonidine for long-term BP control in the HD population.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

The Safety and Efficacy of Clonidine in Hemodialysis Patients: A Systematic Review and Meta-Analysis

Derk

Barton

An³

et al. 2022

Pharmacology

View full text Add to dashboard Cite

show abstract

“…It has recently been reported that clonidine has no sexual side effects [36]. They block transmission of nerve impulses at the intermediate ganglion of both the sympathetic and parasympathetic nervous system and can cause both erectile and ejaculatory difficulties.…”

Section: P E R I P H E R a L L Y A C T I N G Drugs W H I C H May I M mentioning

confidence: 99%

Sex and Drugs

Munjack

1979

Clinical Toxicology

View full text Add to dashboard Cite

Many researchers have felt that there are "sex centers" in the brain that can, in theory at least, be stimulated o r inhibited by various chemicals and drugs. The search for a true aphrodisiac or sexual stimulant has gone on for a very long time. Most of the drugs that affect sexuality seem, unfortunately, to depress sexual drive and responsiveness rather than facilitate it. There appear to be some drugs, however, that in certain individuals and perhaps by a variety of mechanisms do seem to enhance sexual response. H o r m o n e sIt is clear that hormones have many sites of action and varied physiologic effects. One seems to be that androgen, i.e., testosterone, can act in the brain to increase sexual desire in both genders [22, 281. 75

show abstract

Combined Clonidine-Chlorthalidone Therapy in Hypertension

Rosenman¹

1975

Arch Intern Med

View full text Add to dashboard Cite

Clonidine in the Treatment of Severe Hypertension

Cited by 44 publications

References 12 publications

The Safety and Efficacy of Clonidine in Hemodialysis Patients: A Systematic Review and Meta-Analysis

The Safety and Efficacy of Clonidine in Hemodialysis Patients: A Systematic Review and Meta-Analysis

Sex and Drugs

Combined Clonidine-Chlorthalidone Therapy in Hypertension

Contact Info

Product

Resources

About