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European Heart Journal 1984 5(12):1036-1042;
Copyright © 1984 by the European Society of Cardiology.
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© 1984 The European Society of Cardiology

Changes in cardiac function after effective treatment of hypertensive emergencies with i.v. clonidine

G. MASOTTI, L. SCARTI, L. POGGESI, G. BISI*, C. GALLINI* and G. G. NERI SERNERI

Istituto di Clinica Medica 1, Università di Firenze
*Istituto di Medicina Nucleare e Fisica Medica, Università di Firenze

Received 25 April 1984; revised 8 October 1984; .

Address for reprints: Prof. Giutio Masotti. Clinics Media I. Viale Morgagni 85, 50134 Firenze, Italy.

Abstract

Clonidine administration by i.v. infusion in 12 patients with hypertensive emergencies (diastolic blood pressure over 130 mmHg) resulted in the normalization of blood pressure (BP) in all patients. Lowering of BP was associated with a reduction in total and lower limb vascular resistance. Heart rate showed a slight and brief decrease. Cardiac performance (determined by radionuclide angiocardiography) was improved as indicated by the significant increase of ejection fraction and decrease of both end-diastolic and end-systolic volumes.

The dosage of clonidine was progressively increased until a normal BP (mean BP ≤105 mmHg) was obtained. In all patients a normal BP was achieved and in none was an initial hypertensive effect observed. The total mean dose required for control of BP was 382.5±98.3 µg, administered over a mean period of 26.5±4.6 min.

Side-effects, represented by dry mouth and drowsiness, were well tolerated and of short duration. It is concluded that clonidine is an effective and safe alternative in the treatment of hypertensive emergencies.

Key Words: Hypertensive emergencies • clonidine • cardiac performance • antihypertensive drugs


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