Orally Administered Methyldopa

Kranz, Paul; Haft, Jacob I.; Venkatachalapathy, D.; Shahabadi, Ala-Eddin

doi:10.1001/archinte.1974.00320210088012

Cited by 9 publications

(3 citation statements)

References 29 publications

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“…Although the clinical importance of an impairment in these indices of cardiac performance is unknown, the PEP/L VET ratio is felt to be a more sensitive index of left ventricular dysfunction than either the cardiac or stroke index. 12 Furthermore, Kranz and co-workers 4 have shown a decrease in cardiac and stroke index during methyldopa therapy in hypertensive patients with congestive heart failure. It therefore is possible that this difference in the effects of the 2 drugs in PEP/ LVET might be of clinical importance in hypertensive patients with a high degree of compromised cardiac function.…”

Section: Discussionmentioning

confidence: 99%

“…The development of overt congestive heart failure in hypertensive patients treated with methyldopa may reflect this possibility. 4 Methyldopa also might predispose to congestive heart failure because of its ability to decrease sodium excretion. 6 In contrast, guanabenz has shown no tendency to reduce 24-hr urinary sodium excretion after I wk of effective antihypertensive therapy and no weight gain was observed after 6 mo of therapy.2…”

Section: Discussionmentioning

confidence: 99%

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Guanabenz and methyldopa on hypertension and cardiac performance

Walker

Shah

Ramanathan

et al. 1977

Clin Pharma and Therapeutics

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In previous placebo-controlled studies, guanabenz was shown to be a safe and effective antihypertensive drug without acute effects on cardiac function. In view of its therapeutic advantages, a double-blind comparison of guanabenz with methyldopa was performed in a group of 36 patients over 6 mo. Both drugs produced statistically and clinically significant decreases in blood pressure with similar side effects. No laboratory or electrocardiographic abnormalities were found other than positive Coombs' tests which developed in 3 patients during methyldopa therapy. Cardiac performance in 26 of the patients, as measured by noninvasive techniques, showed no significant changes from either drug except for a progressive and statistically significant increase in systolic time interval (QS2) and the ratio of the pre-ejection period to left ventricular ejection time (PEP/LVET) during methyldopa therapy. For an additional 6 mo, continued efficacy and safety were shown under open conditions in those patients who had received guanabenz. The study suggests that guanabenz may be an important new antihypertensive drug because of effectiveness, absence of adverse cardiac effects, and paucity of side effects.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Guanabenz and methyldopa on hypertension and cardiac performance

Walker

Shah

Ramanathan

et al. 1977

Clin Pharma and Therapeutics

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“…Methyldopa is generally well tolerated in these patients; however, some reports of exacerbation of congestive heart failure have appeared in the literature [27], Fig. 9.…”

Section: Hypertension and Congestive Heart Failurementioning

confidence: 98%

Management of Hypertension in Patients with Concomitant Diseases

Okun¹

1987

Cardiology

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The treatment of hypertension in patients with diabetes, obstructive airway disease, impaired renal function, or congestive heart failure (CHF) is discussed. Specifically, the value of α₁-adrenoceptor blocking agents in such patients is reviewed. An individualized approach to therapy is required, with careful consideration of the effects of different drugs on the existing metabolic and hemodynamic situation. In diabetic individuals, commonly used step-1 agents may impair glucose tolerance; β-adrenergic blockade may increase blood glucose levels and significantly change response to insulin-induced hypoglycemia. Diabetic patients may also be especially sensitive to side effects of some centrally acting antihypertensive agents. In patients with obstructive airway disease, β-blockade and α-stimulation worsen bronchospasm; although β-stimulants produce bronchodilatation, they often are contraindicated in hypertensive patients due to their stimulatory effects on the heart. In patients with impaired renal function, therapy for hypertension may include problems such as an increased half-life of antihypertensive agents and retention of active metabolites. In patients with CHF, if blood pressure is not normalized with diuretics, more aggressive therapy may be required. According to results of several studies discussed, the α₁-adrenoceptor blocking agent prazosin appears to be a safe and effective therapy, causing a minimum of side effects, for treatment of hypertension in patients with these conditions.

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Use of Centrally Acting Sympatholytic Agents in the Management of Hypertension

Oster

Epstein²

1991

Arch Intern Med

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Orally Administered Methyldopa

Cited by 9 publications

References 29 publications

Guanabenz and methyldopa on hypertension and cardiac performance

Guanabenz and methyldopa on hypertension and cardiac performance

Management of Hypertension in Patients with Concomitant Diseases

Use of Centrally Acting Sympatholytic Agents in the Management of Hypertension

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