Key result
Adding low-dose reserpine (0.05 to 0.125 mg) to chlorthalidone achieved blood pressure control in 58% to 69% of patients, with the 0.05-mg dose causing one third the side effects of the 0.25-mg dose.
Why the study?
Do low doses of reserpine reduce blood pressure effectively with fewer side effects compared to standard-dose reserpine when added to chlorthalidone in patients with mild to moderate hypertension?
RCT (n=329)
Double-blind
random
Yes
Do low doses of reserpine reduce blood pressure effectively with fewer side effects compared to standard-dose reserpine when added to chlorthalidone in patients with mild to moderate hypertension?
Lower than customary doses of reserpine combined with a diuretic can effectively control hypertension while significantly reducing side effects like lethargy and impotence.
Low-dose reserpine with chlorthalidone supports effective hypertension control with improved tolerability; extends RCT evidence for dose optimization in guidelines.
Reserpine in different doses was assigned in random, double-blind fashion to 329 patients with mild to moderate hypertension who had not achieved normotension with chlorthalidone therapy alone. The additional reduction of BP averaged 11.0/10.4 mm Hg with chlorthalidone, 50 mg, plus reserpine, 0.25 mg (C 50+R 0.25); 9.5/9.4 mm Hg with C 50+R 0.125; 6.4/8.5 mm Hg with C 50+R 0.05; and 9.9/9.6 mm Hg with C 25+R 0.125. The percentage of patients in whom control was achieved at diastolic BP less than 90 mm Hg and at least 5 mm Hg below baseline with either chorthalidone alone or with reserpine added was 65% with C 50+R 0.25, 69% with C 50+R 0.125, 58% with C 50+R 0.05, and 56% with C 25+R 0.125. Side effects of lethargy and impotence noted by patients with the 0.05-mg dose of reserpine were only one third of those noted with the 0.25-mg dose, although the incidence of other side effects did not differ. These results indicate that hypertension in many persons can be controlled by less than customary doses of reserpine in combination with a diuretic.
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A 1982 study conducted an RCT in mild to moderate hypertension (n=329). Reserpine vs. Different doses of reserpine was evaluated on Percentage of patients achieving diastolic BP < 90 mm Hg and at least 5 mm Hg below baseline. Adding low-dose reserpine (0.05 to 0.125 mg) to chlorthalidone achieved blood pressure control in 58% to 69% of patients, with the 0.05-mg dose causing one third the side effects of the 0.25-mg dose.
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