Pargyline Hydrochloride and Amine Hypertension

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Abstract
The Out-Patient Hypertensive Clinic at Abington Memorial Hospital was studied. Thirty eight patient with an average age of 56 years and 18 years'' duration of hypertension. Twenty-eight patients have completed the study. This consisted of: a control period of approximately 4 weeks at which time their blood pressures were measured and their chemistries obtained. They were treated for approximately 5 weeks with the diuretic methyclothiazide at an average dose of 8 mg, and there was a significant difference in their sitting, standing, and lying blood pressure while on this medication. After 11 weeks of pargyline therapy at an average dose of 60 mg there was a significant difference in the sitting, standing, and lying pressures from placebo. It was at the 99% level in the sitting and standing position, while only at the 95% level in the lying position. The combination of drugs for approximately 10 weeks using an average dose of methyclothiazide, 5 mg, and parglyine, 45 mg, and showed a significant reduction in the blood pressure in all 3 positions, being less significant in the diastolic lying position, being only at the 9 5% level, the rest being at 99% level of significance. Between the standing systolic and mean blood pressures for these 2 agents. This demonstrates the efficacy of the drug alone and in combination, it also shows that in combination it is also shows that in combination it is more efficient in the lying position, thus increasing the length of time through the day when the drug is effective. A decrease in serum K and an elevation of the uric acid when the diuretic was added. It had an elevation on the blood sugar level but this was not statistically significant. A study of the possibility of liver toxicity revealed in all patients the cephalin flocculation and the serum glutamic-pyruvic transaminase to be absolutely normal, and a screening test for abnormalities of clotting mechanism using the partial thromboplastin time was within entirely normal range of all patients. Ten patients failed to complete the study. One was unreliable, 3 had cerebral vascular accidents, one had acute asthma, one patient in malignant phase could not wait for the thera-peutic effect of the drug, three returned to family doctor, and one who described passing out refused to take the medication again. Of the reported side effects there were no symptoms in 12 out of 38 patients on placebo, 12 of 33 on parglyine, 10 of 36 with the combination, and 10 of 29 on diuretic. Three cases of amine hypertension were recorded by history while on pargyline, 2 patients had unsubstantiated blackouts on combination, and one patient had a nosebleed on parglyine. There were other reports of impotency, loss of libido, euphoria, skin rashes with spontaneous recovery, and several had unaccounted chest pain. On final placebo 3 patients did develop cerebral vascular accidents, cause unknown. One personally observed amine hypertension is reported in detail. No evidence of tolerance was seen. The authors reported their findings by use of Ishihara eye chart. Indications and contra-indications of both hypertensive and hypotensive reactions are outlined.

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