Oral Clonidine Loading in Hypertensive Urgencies

Abstract

The response to oral clonidine hydrochloride loading in 36 severely hypertensive patients is presented. Each patient initially received 0.2 mg of clonidine hydrochloride, followed by 0.1 mg each hour until a dose of 0.7 mg had been given, or the diastolic blood pressure (BP) reached a predetermined goal (110 mm Hg or total fall of at least 20 mm Hg). Only two patients (6%) failed to reach this goal. Supine BP in the group fell from 212 +/- 22 (SD)/139 +/- 11 (SD) mm Hg to 151 +/- 21 (SD) mm Hg at six hours. The average dose of clonidine required was 0.45 mg and control was maximized at five hours. The response to oral clonidine loading in the individual patient was not predictive of the eventual dose of clonidine necessary to achieve acceptable BP control at two weeks. Oral clonidine loading is safe and effective in the management of "hypertensive urgencies" and offers several advantages over parenteral antihypertensive agents in this clinical situation.

Oral Nifedipine vs Oral Clonidine in the Treatment of Urgent Hypertension

“…Eighty-three percent of the patients (19/23) reached this goal at 45 minutes or less (Fig 1). The mean decrease in diastolic blood pressure at 45 minutes in all patients receiving nifedipine was 29 mm Hg (range, 8 to 55 mm Hg). The mean decrease in systolic blood pressure at 45 minutes for all patients receiving nifed¬ ipine was 47 mm Hg (range, 15 to 96 mm Hg) (Fig 2).…”

Clinical presentation and management of patients with uncontrolled, severe hypertension: results from a public teaching hospital

“…Accordingly, in the absence of detailed management guidelines and algorithms supported by data from the appropriate clinical trials, practitioners employ a number of diverse protocols, with quite varied results. [22][23][24][25][26][27][28][29][30][31][32][33] …”

Use of oral antihypertensive medication preceding blood pressure elevation in hospitalized patients

“…It is also important to observe that hypertensive patients experience a decrease in blood pressure after being admitted to the hospital regardless of the treatment [2][3][4][5] . In the last 2 decades, antihypertensive medications that act quickly after oral or sublingual administration [6][7][8][9][10][11][12] have been used. The ease of administering such drugs contributes to their prescription before elevation of blood pressure.…”