Comparison of debrisoquine and guanethidine in treatment of hypertension.

Abstract

SummaryA cross-over trial of debrisoquine and guanethidine in 32 patients showed that both drugs were equally effective in lowering both systolic and diastolic blood pressure. The degree to which they were tolerated by the patients, however, differed greatly. After three months on each drug 18 patients preferred debrisoquine, nine preferred guanethidine, and five showed no particular preference. At current prices the cost of daily treatment to the patient was cheaper with debrisoquine than with guanethidine. IntroductionPublished work shows that both guanethidine and debrisoquine are potent hypotensive agents in the management of moderate to severe cases of hypertension. Though both drugs act on the postganglionic sympathetic nerves, interfering with the release of noradrenaline at their nerve endings, their side effects though similar are not equally severe. Heffernan and Carty (1970) in their initial studies with debrisoquine were impressed with the low incidence of side effects. Though bethanidine, guanethidine, and methyldopa (Prichard et al., 1968) and debrisoquine and methyldopa (Heffernan et al., 1971) have been compared there has been no formal comparative clinical trial between debrisoquine and guanethidine. We therefore made a within-patient comparison of the effectiveness and tolerability of debrisoquine and guanethidine using the principles (with slight modifications) established by Prichard et al. (1968).

Comparative studies of guanfacine and methyldopa.

“…For statistical evaluation the last values of blood pressure and pulse rate before withdrawing the drug were used. To evaluate the efficacy of both drugs the following criteria were used (Adi, Eze & Anwunah, 1975;Holzgreve, 1973;Oates, Gillespie, Udenfriend & Sjoerdsma, 1960;Weddell, 1973): 'good control' (< 160/100, > 145/95 mmHg); 'normalization' (< 145/95 mmHg); 'bad response' (> 160/100 mmHg). The decrease in mean arterial blood pressure (MAP = BP diastolic + 1/3 (BP systolic BP diastolic) was expressed as a percentage.…”