What is the clinical evidence from this study?

Study design: Observational. Population: Hypertensive urgencies (n=36). Intervention: Oral clonidine hydrochloride loading. Primary outcome: Diastolic blood pressure goal of 110 mm Hg or total fall of at least 20 mm Hg.

What question did this study set out to answer?

To evaluate the efficacy and safety of hourly oral clonidine loading for acute blood pressure reduction in patients presenting with hypertensive urgencies.

August 21, 1981JAMA

Oral Clonidine Loading in Hypertensive Urgencies

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Key result

Oral clonidine loading achieved the predetermined diastolic blood pressure goal in 94% of severely hypertensive patients.

Why the study?

Does oral clonidine loading effectively reduce blood pressure in patients with hypertensive urgencies?

Key Points

To evaluate the efficacy and safety of hourly oral clonidine loading for acute blood pressure reduction in patients presenting with hypertensive urgencies.
Enrolled 36 patients with severe hypertension to receive an initial oral dose of 0.2 mg clonidine hydrochloride.
Administered 0.1 mg hourly thereafter until reaching a target diastolic blood pressure of ≤110 mm Hg, a drop of ≥20 mm Hg, or a maximum cumulative dose of 0.7 mg.
A total of 34 of 36 patients (94%) attained the blood pressure goal, with an average required dose of 0.45 mg and maximum control achieved at 5 hours.
Supine blood pressure decreased from baseline values of 212 ± 22 / 139 ± 11 mm Hg to 151 ± 21 mm Hg systolic at 6 hours, though acute response did not predict the dosage required at 2 weeks.

Study Design

Type

Observational (n=36)

Structured PICO

Does oral clonidine loading effectively reduce blood pressure in patients with hypertensive urgencies?

Population

36 severely hypertensive patients treated with oral clonidine loading and evaluated for blood pressure control.

Exposure

Oral clonidine hydrochloride loading (initial 0.2 mg, followed by 0.1 mg each hour until a dose of 0.7 mg had been given or blood pressure goal reached)

Outcome

Achievement of predetermined diastolic blood pressure goal (110 mm Hg or total fall of at least 20 mm Hg)surrogate

Oral clonidine loading is an effective and safe strategy for rapidly lowering blood pressure in patients presenting with hypertensive urgencies.

Discussion

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Implication

Supports clonidine loading in hypertensive urgencies; hypothesis-generating and requires randomized confirmation before practice change.

Cite This Study

Ron J. Anderson (1981) conducted an observational in Hypertensive urgencies (n=36). Oral clonidine hydrochloride loading was evaluated on Diastolic blood pressure goal of 110 mm Hg or total fall of at least 20 mm Hg. Oral clonidine loading achieved the predetermined diastolic blood pressure goal in 94% of severely hypertensive patients.

synapsesocial.com/papers/6a8d938fdafbba83333157be https://doi.org/10.1001/jama.1981.03320080034024

Topics

Hypertension management

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Oral Clonidine Loading in Hypertensive Urgencies

Key Points

Study Design

Structured PICO

Discussion

Implication

Cite This Study

Topics

Oral Clonidine Loading in Hypertensive Urgencies

Key Points

Study Design

Structured PICO

Discussion

Implication

Cite This Study

Also Consider

Topics

Also Consider