Treatment of Essential Hypertension with Combined Vasodilation and Beta-Adrenergic Blockade

Abstract

Twenty-three patients with moderate or severe essential hypertension were treated with a combination of diuretic, propranolol and hydralazine. In 20 of these patients blood pressure had not been satisfactorily controlled by diuretics, methyldopa and guanethidine. Daily propranolol dosage was 80 to 160 mg (mean, 143), and that of hydralazine 40 to 400 mg (mean, 225). The mean blood-pressure reduction achieved by combined beta-adrenergic blockade and vasodilation was 46/30 mm of mercury in the lying and 42/32 mm of mercury in the standing position. Diastolic arterial pressure was reduced below 100 mm of mercury in 21 patients and to 90 mm or less in 17 patients. This effective antihypertensive action was not associated with postural hypotension, tachycardia, other hemodynamic disturbances, impairment of renal function or adverse symptoms in any patient. The absence of side effects caused strong patient preference for the combination of propranolol and hydralazine over sympathoplegic drugs.