The Role of Postganglionic Sympathetic Blockade in Antihypertensive Therapy
- J. Marion Bryant, MD;
- Lucian Fletcher Jr., MD;
- Natalio Schvartz, MD;
- Harrison Fertig, MD;
- Richard B. F. Quan, MD
Abstract
Currently, neurogenic blockade is used as a supplement to sulfonamide-diuretics (with or without reserpine) when optimal antihypertensive control is not obtained with these drugs alone. Although the use of neurogenic blocking agents preceded that of sulfonamide-diuretics by ten years, the latter have become first in therapeutic choice.
A combination of chlorthalidone and reserpine produced normotension in 58 of 100 ambulatory outpatients with moderate to severe essential hypertension. Twentytwo of 42 subjects with residual hypertension became normotensive when chlorthalidone-reserpine therapy was augmented with a postganglionic sympathetic blocking agent (debrisoquin sulfate).
In the authors' opinion neurogenic blocking agents, or other potent antihypertensive drugs as adjuncts to sulfonamide-diuretics, are indicated in approximately 40% of patients with moderate or severe essential hypertension. Debrisoquin appears to be more practical, as a supplementary antihypertensive drug, than older related blocking agents.
Footnotes
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Reprint requests to New York University School of Medicine, 550 First Ave, New York 10016 (Dr. Bryant).
