Effect of guanfacine on ambulatory blood pressure and its variability in elderly patients with essential hypertension.

Abstract

1 The effect of guanfacine (2 mg once daily) on ambulatory blood pressure was studied with the Remler M 2000 recorder in 16 elderly hypertensive patients during a randomized, double-blind, placebo-controlled, balanced, cross-over study. 2 Guanfacine significantly reduced heart rate and systolic and diastolic ambulatory blood pressure. The antihypertensive effect was maintained over the whole recording period. 3 Systolic and diastolic blood pressure variability was not changed by guanfacine, neither when defined as standard deviation or variation coefficient of the mean, nor when defined as the range between the highest and lowest ambulatory blood pressure, suggesting that blood pressure variability is unrelated to sympathetic nervous system activity.

Pharmacokinetics and pharmacodynamics of guanfacine extended release in adolescents aged 13–17 years with attention‐deficit/hyperactivity disorder

“…Consistent with guanfacine's known effects as an antihypertensive and similar to previous studies of guanfacine extended release, guanfacine extended release was associated with a dose‐dependent decrease in BP and HR. In this study, it was shown that the physiologic HR response to standing (i.e., an increase) is preserved during treatment with guanfacine extended release.…”

“…Guanfacine decreases blood pressure (BP) and heart rate (HR) through stimulation of α 2 ‐adrenoceptors in the brain stem . Several studies of adult subjects with mild to moderate hypertension have found that treatment with guanfacine (1–3 mg/day) significantly reduced both seated and standing systolic BP (SBP) and diastolic BP (DBP) as well as HR . Rebound hypertension and increases in HR have been noted upon rapid withdrawal of clonidine, another α 2 ‐adrenergic agonist, in hypertensive patients .…”

“…[1][2][3][4][5] Several studies of adult subjects with mild to moderate hypertension have found that treatment with guanfacine (1-3 mg/day) significantly reduced both seated and standing systolic BP (SBP) and diastolic BP (DBP) as well as HR. [6][7][8][9][10] Rebound hypertension and increases in HR have been noted upon rapid withdrawal of clonidine, another a 2 -adrenergic agonist, in hypertensive patients. 1,2,4,6,10 Less pronounced effects have been noted after treatment with guanfacine, although withdrawal symptoms remain an important clinical consideration.…”

Twenty-Four hour ambulatory blood pressure profile of a new slow-release formulation of diltiazem in mild to moderate hypertension

“…As we observed in earlier studies, baseline office blood pressures were higher than the corresponding ambulatory blood pressure [21,22], and some patients who were diagnosed as having hypertension based on their clinic blood pressure appeared to have normal ambulatory blood pressure when the same criteria were used [22]. A previous study showed that diltiazem decreased the average whole-day blood pressure in patients whose clinically diagnosed hypertension was confirmed by pretreatment ambulatory blood pressure monitoring, but not in those in whom this was not the case [10].…”

Not first‐line antihypertensive agents, but still effective—The efficacy and safety of imidazoline receptor agonists: A network meta‐analysis

“…Comorbidities as exclusion factors were varied from study to study; these criteria are in Table S4 . In 15 studies, blood pressure was measured in supine position, 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 in 11 studies in standing position, 19 , 20 , 21 , 22 , 25 , 26 , 27 , 28 , 32 , 34 , 35 and in six studies in sitting position. 33 , 34 , 36 , 37 , 38 , 39 The antihypertensive efficacy of imidazoline receptor agonists could be meta‐analysed based on 27 studies, in which blood pressure was measured in supine position in 15 studies: four studies at 2 weeks, two studies at 3 weeks, eight studies at 4 weeks, two studies at 6 weeks, six studies at 8 weeks, and one at 12 weeks.…”