The Drug Treatment of Hyperpiesia

Abstract

The more numerous the remedies for a disease the less likely that any will prove consistently helpful. Of the many drugs recommended for hyperpiesia (essential hypertension) there is no agreement on the best to employ, and none has gained any outstanding reputation. There seems to be no authoritative statement on the comparative value of these remedies, and individual drugs have been praised without controlled clinical observations. The urge for trying new remedies in hyperpiesia is prompted by the common incidence of a condition which produces bizarre symptoms and determines many complications. Although for this reason treatment is a matter of great concern, it is not likely to be very successful while the cause remains unknown.This paper deals primarily with the effects of certain drugs on the blood pressure in patients with hyperpiesia, and also records our observations on the influence of changes in the blood pressure on the subjective symptoms. We are not concerned here with the advisability of reducing blood pressure in hyperpiesia, but our findings during short periods of a lowered pressure have convinced us that the presence of symptoms has little or no relation to the level of the blood pressure. The opportunity, however, of observing the results of a greatly lowered blood pressure in hyperpiesia over a long period has only been gained through the onset of cardiac infarction or heart failure, when the appearance of newer symptoms might mask the direct effects of the lowered pressure. METHOD OF OBSERVATIONWe submitted the following preparations to clinical trial: sodium nitrite, glyceryl trinitrate, erythrol tetranitrate, mannitol hexanitrate, bismuth subnitrate, potassium iodide, iodine, potassium bromide, sodium luminal, chloral hydrate, papaverine sulphate, euphyllin, diuretin, theominal, doryl, pacyl, hypotan, calcium chloride, atropine, potassium thiocyanate, benzyl benzoate, guipsine, detensyl, phyllosan, citrin, yohimbine hydrochloride, padutin, vagotonine, angioxyl, bioglan H, anabolin, perandren, and cestrone. We selected these remedies either on account of a reputation which they already held in the treatment of hyperpiesia or on account of their pharmacological action in producing a fall in blood pressure. Many of the proprietary preparations were 199

A Clinical Trial of Rauwolfia Serpentina in Essential Hypertension

“…No serious reactions to therapy were encountered in any of the cases. R. Serpentina, therefore, satisfies all the criteria of a successful hypotensive agent formulated by Evans and Loughnan (1939). Judging from the results of the present investigation, it has a definite place in the treatment of cases of high blood pressure.…”

Overview of the Evolution of Hypertension: From Ancient Chinese Emperors to Today

“…In the late 19th and early to mid-20th century, many therapies were used to treat hypertension, but few were effective, 18 and most were poorly tolerated. 19 Treatments used in the period before the 1950s, when better tolerated…”

“…In the late 19th and early to mid-20th century, many therapies were used to treat hypertension, but few were effective, 18 and most were poorly tolerated. 19 Treatments used in the period before the 1950s, when better tolerated antihypertensive agents were developed, included strict sodium restriction (using a rice diet), sympathectomy (surgical ablation of parts of the sympathetic nervous system in the spine), and pyrogen therapy (injection of substances that caused a fever, indirectly reducing BP).…”

Thiocyanate and Basal Blood Pressure

“…For example, Ayman (1930Ayman ( , 1931 endeavoured to show that their effect was nm,i not greater than that of placebos, basing his criteria of action mainly on symptomatic improvement and not so much on pressure changes. 0\ Evans and Loughnan (1939) There have been, however, a number of careful investigations (Daley et al, 1943 ;Beamish and Adamson, 1945;Watkinson and Evans, 1947) in which every precaution was taken to control and standardize conditions and in which it would seem that thiocyanates did produce significant falls in the systolic and diastolic blood pressures.…”