THERAPEUTICALLY "REFRACTORY" HYPERTENSION: CAUSATIVE FACTORS, AND MEDICAL MANAGEMENT WITH CHLOROTHIAZIDE AND OTHER AGENTS

Publisher Website
Google Scholar
Abstract
Thirty-five cases of refractory hypertensive disease were treated with chlorothiazide 1.0 gm/day, added to drugs that previously were ineffective in lowering their blood pressure. All but 3 cases showed a prompt and impressive hypotensive response. The mechanism of action was not thought to be due exclusively to electrolyte loss. Side reactions to chlorothiazide were minor, generally, and of 4 types; gastrointestinal, hemorrhagic, cardiac, and possibly central nervous. Cardiac arrythmias were occasionally distressing, but were not related to electrolyte changes in the plasma. Therapy of hypertensive disease should begin with milder drugs, such as reserpine and hydralazine; if no response is found, chlorothiazide should be added to them, with appropriate chemical follow up and control. Failure to obtain a blood pressure reduction at this point is reason for supplementing these drugs with the autonomic blocking compounds, in appropriate patients.

This publication has 2 references indexed in Scilit: