Sixteen patients with mild to moderate essential hypertension (eight with clinical congestive heart failure [CHF], and eight without CHF) were studied before and during treatment of hypertension with 0.5 to 2.0 gm of orally given methyldopa in daily divided doses. Blood pressures fell equivalently in both groups. Cardiac index (CI) and stroke index (SI) responses were variable in those patients without CHF, but mean CI and mean SI were statistically unchanged during treatment. All eight patients with CHF demonstrated a reduction of CI and five demonstrated a reduction of SI during treatment. Mean CI was significantly lowered during treatment in those patients with CHF. Mean SI was significantly lower in those patients with CHF than in those without CHF during treatment, although it had been statistically the same prior to treatment. Treatment of hypertension with orally given methyldopa in the presence of CHF is likely to lead to a reduction of the cardiac output.
Kranz PD, Haft JI, Venkatachalapathy D, Shahabadi A. Orally Administered Methyldopa: Hemodynamic Effects in the Presence and Absence of Congestive Heart Failure. Arch Intern Med. 1974;134(3):478–483. doi:10.1001/archinte.1974.00320210088012
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