Key result
Long-term guanfacine is linked to ~92% fewer cardiovascular complications versus no treatment over 3 years.
Why the study?
The long-term effects of guanfacine treatment on blood pressure, cardiovascular complications, renin, and prolactin in patients with mild to moderate hypertension were not well characterized.
Does long-term treatment with guanfacine improve blood pressure and reduce cardiovascular complications in patients with mild to moderate hypertension?
Cohort (n=62)
Does long-term treatment with guanfacine improve blood pressure and reduce cardiovascular complications in patients with mild to moderate hypertension?
Absolute Event Rate: 2.2% vs 29%
Long-term guanfacine treatment effectively controls blood pressure and is associated with a lower incidence of cardiovascular complications compared to no treatment in mild to moderate hypertension.
Should not yet change practice; leaves open whether randomized trials confirm guanfacine benefit.
SummaryThe effect of long-term treatment with guanfacine on blood pressure, heart rate, plasma renin activity (PRA) and prolactin was studied in 45 patients with mild to moderate hypertension over a period of 3years. An average daily dose of 2.8 mg guanfacine produced satisfactory control of blood pressure and there was a significant reduction in mean arterial pressure in all cases. During the first year of treatment, tolerance of guanfacine developed in 30 (67%) patients but this was significantly lower in the second and third years and was successfully overcome with the addition of chlorthalidone (50 mg/day) to the treatment regimen for 1 month. No correlation was demonstrated between the reduction in blood pressure and the effect of guanfacine on PRA and prolactin levels. Prolactin decreased significantly after 3 months of treatment while a late inhibition in PRA levels was observed. However, guanfacine inhibited early in treatment the diuretic-induced renin increase. The incidence of cardiovascular complications during the course of treatment with guanfacine (I case of stroke: 2.2% of patients) was compared to that in a non-treated group during 3 years of observation (17 patients: 5 cardiovascular accidents: 29% of patients). The development of cardiovascular accidents was associated with an increase in PRA and prolactin levels.
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Hauger-Klevene et al. (1982) conducted a cohort in mild to moderate hypertension (n=62). Guanfacine vs. Non-treated group was evaluated on Cardiovascular complications. Long-term treatment with guanfacine was associated with a lower incidence of cardiovascular complications compared to a non-treated group (2.2% vs 29%) over 3 years.
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