THE MOST POTENT antihypertensive agents presently available are those which interfere with function of the sympathetic nervous system. Methyldopa (the levo isomer of alphamethyldopa), which is an effective decarboxylase inhibitor, diminishes the formation of catecholamines by inhibiting the conversion of dihydroxyphenylalanine (dopa) to dopamine.1 Although it is not known whether the fall in blood pressure produced by this drug depends upon interference with sympathetic function, its antihypertensive effects are similar to those of other autonomic blocking agents.2,3 It has been shown to be effective in the treatment of hypertension and reasonably free from side effects, and others have emphasized that it has a favorable effect on the recumbent blood pressure.4-7
Since effective drugs of this type are presently available, the place of methyldopa in the treatment of hypertension will be determined by its ability to overcome the deficiencies in the other autonomic blocking agents, notably guanethidine sulfate.
James Conway, Andrew J. Zweifler, Stevo Julius. The Place of Methyldopa in the Treatment of Severe Hypertension. JAMA. 1963;186(3):266–268. doi:10.1001/jama.1963.63710030042021d