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July 11, 1966

Treating Refractory Hypertension

JAMA. 1966;197(2):42. doi:10.1001/jama.1966.03110020028016

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Therapy-resistant hypertensive patients have been treated successfully with an experimental agent, Georgetown University clinicians report.

Effects of a 20-day regimen of diazoxide have elicited responsiveness to standard agents for as long as two years.

A clinical trial with 16 hypertensive patients was reported to the American Therapeutic Society by Frank A. Finnerty, Jr., MD.

All cases previously were amenable to therapy. Drug resistance, failure to take medications correctly or aggravated vascular disease caused accelerated hypertension.

Doses of methyldopa, guanethidine and hydralazine were increased to near toxic levels. In spite of this there was mean 33% arterial pressure increase.

"Flame shaped" hemorrhages and increased cardiac size also were detected in 11 of the 16 patients. Congestive heart failure developed in seven.

After hospital confinement to assure that out-patient factors were not critical, diazoxide was begun.

For 20 days, intravenous doses of 300 mg were given as often as necessary to maintain

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