[Skip to Content]
[Skip to Content Landing]
Article
September 1960

Sequential Changes Evoked by Chlorothiazide in Hypertensive Patients

Author Affiliations

Cleveland

From the Research Division of the Cleveland Clinic Foundation and the Frank E. Bunts Educational Institute.

Arch Intern Med. 1960;106(3):316-320. doi:10.1001/archinte.1960.03820030004002
Abstract

Enhanced responsiveness to ganglioplegic drugs occurring during short-term treatment with chlorothiazide has been attributed to increased vasomotor tone evoked by oligemia.1 Diuretic-induced oligemia also seems responsible for increased depressor responses to trimethapan (Arfonad) and decreased pressor responses to norepinephrine.2 Chlorothiazide alone can lower arterial pressure in some hypertensive patients,1-3 and this effect may result from a decrease of plasma volume. This report describes the oligemic and antihypertensive effects of the diuretic in hypertensive patients receiving the drug for varying periods. The results support the suggestion 1 that decreases of arterial pressure observed during short-term diuretic therapy result from decreases of plasma volume and not from a specific antihypertensive effect.

Methods  Studies were performed in 17 hypertensive patients hospitalized in the Research Ward of the Cleveland Clinic Hospital. Fifteen received a 100 mEq. sodium diet, and two—who had previously suffered from congestive cardiac failure—continued to take a 55

References
1.
Supplied by Dr. John Beem, Merck Sharp and Dohme, Division of Merk & Co., Inc.
2.
Dustan, H. P.; Cumming, G. R.; Corcoran, A. C., and Page, I. H.:  A Mechanism of Chlorothiazide-Enhanced Effectiveness of Antihypertensive Ganglioplegic Drugs ,  Circulation 19:360 ( (March) ) 1959.Crossref
3.
Freis, E. D.:  The Effects of Salt and Extracellular Fluid Depletion on Vascular Responsiveness with Particular Reference to Chlorothiazide ,  Proc. Council for High Blood Pressure Research 7:6, 1958.
4.
Finnerty, F. A.; Bucholz, J. H.; Tuckman, J., and Hajjar, G. T.:  Evaluation of Chlorothiazide Alone in the Treatment of Moderately Severe and Severe Hypertension ,  Circulation 18: 718 ( (Oct.) ) 1958.
5.
Hlad, C. J., Jr., and Tanz, R.:  An Analysis of Technical Errors in Radioalbumin Blood Volume Methods and Presentation of a Modified Method ,  J. Lab. & Clin. Med. 52:289 ( (Aug.) ) 1958.
6.
Dollery, C. T.; Harington, M., and Kaufmann, G.:  The Mode of Action of Chlorothiazide in Hypertension ,  Lancet 1:1215 ( (June 13) ) 1959.
7.
Wilkins, R. W.; Hollander, W., and Chobanian, A. V.:  Chlorothiazide in Hypertension: Studies on Its Mode of Action ,  Ann. New York Acad. Sc. 71:465 ( (Feb. 3) ) 1958.
8.
Freis, E. D.; Stanton, J. R.; Finnerty, F. A., Jr.; Schnaper, H. W.; Johnson, R. L.; Rath, C. E., and Wilkins, R. W.:  The Collapse Produced by Venous Congestion of the Extremities or by Venesection Following Certain Hypotensive Agents ,  J. Clin. Invest. 30:435 ( (May) ) 1951.
9.
Hollander, W., and Chobanian, A.:  The Mode of Action of Chlorothiazide and Mercurial Diuretics as Antihypertensive Agents , Proc. 50th Ann. Meet. Am. Soc. Clin. Invest., abstracted,  J. Clin. Invest. 37:902 ( (June) ) 1958.
10.
Friedman, S. M.; Jamieson, J. D., and Friedman, C. L.:  Sodium Gradient, Smooth Muscle Tone, and Blood Pressure Regulation ,  Circulation Res. 7:44 ( (Jan.) ) 1959.
×