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March 5, 1982

Clonidine in Hypertensive Urgencies

JAMA. 1982;247(9):1274. doi:10.1001/jama.1982.03320340032015

To the Editor.—  In the recent article on the use of clonidine in hypertensive urgencies (1981;246:848), it seems clear that this agent is effective in those patients with severe hypertension who do not constitute a hypertensive emergency. However, we do have one major concern. The authors mention that 33 of the 36 patients failed to comply with a previously prescribed therapeutic regimen. Clonidine is not a suitable agent to use in noncompliant patients because severe rebound hypertension has been described following its abrupt withdrawal,1,2 particularly when used in substantial doses (the average dose being taken two weeks after discharge was 0.8 mg). Furthermore, a statement on the number of patients previously receiving clonidine would seem appropriate, since this subgroup would respond well to recommencement of clonidine therapy. We would suggest that clonidine administration has a place in the treatment of hypertensive urgencies in those patients whom it is thought will