ABSTRACT
Control of hypertension (ie, reduction of blood pressure to less than or equal to 160/90 mmHg) in 40 mild to moderate hypertensives not responding adequately to hydrochlorothiazide was achieved by the addition of guanfacine (once daily) or methyldopa (twice daily) in a 16-week, double-blind, parallel-group trial. Control occurred after two weeks (at 1 mg/day) in 50% of the guanfacine-treated patients and in most patients within four to six weeks of treatment. The final mean doses were 2.5 mg/day of guanfacine or 763 mg/day of methyldopa. Sixteen patients maintained control of hypertension with continued guanfacine therapy for one year.
Subject(s)
Antihypertensive Agents/therapeutic use , Guanidines/therapeutic use , Hypertension/drug therapy , Methyldopa/therapeutic use , Phenylacetates/therapeutic use , Aged , Antihypertensive Agents/administration & dosage , Antihypertensive Agents/adverse effects , Blood Pressure/drug effects , Clinical Trials as Topic , Double-Blind Method , Drug Administration Schedule , Female , Guanfacine , Guanidines/administration & dosage , Guanidines/adverse effects , Heart Rate/drug effects , Humans , Hydrochlorothiazide/therapeutic use , Hypertension/physiopathology , Male , Methyldopa/administration & dosage , Middle Aged , Phenylacetates/administration & dosage , Phenylacetates/adverse effects , Random Allocation , Time FactorsABSTRACT
The association of anemia with chronic renal disease is well known. The striking hematologic improvement following a successful renal allotransplantation led to the present study. Using radioactive (59)Fe, ferrokinetic measurements were carried out in nine uremic patients (seven with and two without anemia), four post-allotransplant cases, three patients with iron deficiency anemia and a group of five normal subjects. Erythrocyte life-span was calculated by (51)Cr-labelled, autotransfused red cells in all patients who had had transplants and in three patients with renal anemia. The results showed that in patients with renal anemia the plasma radioiron clearance was slightly delayed but the (59)Fe incorporation into the circulating erythrocytes was significantly decreased. Red cell life-span was moderately shortened in two out of three uremic patients investigated. The findings constitute evidence of ineffective erythropoiesis in patients with renal anemia. By comparison, the four transplant patients showed normal (59)Fe plasma clearance and red cell incorporation; the (51)Cr erythrocyte survival was normal in all four patients.
