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September 20, 1965

The Role of Postganglionic Sympathetic Blockade in Antihypertensive Therapy

Author Affiliations

From the Department of Medicine, New York University Medical Center, and the New York University Medical Divisions, Bellevue Hospital, New York.

JAMA. 1965;193(12):1021-1026. doi:10.1001/jama.1965.03090120029007

Currently, neurogenic blockade is used as a supplement to sulfonamide-diuretics (with or without reserpine) when optimal antihypertensive control is not obtained with these drugs alone. Although the use of neurogenic blocking agents preceded that of sulfonamide-diuretics by ten years, the latter have become first in therapeutic choice.

A combination of chlorthalidone and reserpine produced normotension in 58 of 100 ambulatory outpatients with moderate to severe essential hypertension. Twentytwo of 42 subjects with residual hypertension became normotensive when chlorthalidone-reserpine therapy was augmented with a postganglionic sympathetic blocking agent (debrisoquin sulfate).

In the authors' opinion neurogenic blocking agents, or other potent antihypertensive drugs as adjuncts to sulfonamide-diuretics, are indicated in approximately 40% of patients with moderate or severe essential hypertension. Debrisoquin appears to be more practical, as a supplementary antihypertensive drug, than older related blocking agents.