The management of moderately severe hypertension with cryptenamine and rauwolfia: Observations in patients treated for up to two years

Abstract

1. (1) Cryptenamine (unitensen), an alkaloid of veratrum viride, was administered to 41 office patients with arterial hypertension of moderate severity for periods up to two years, by the oral route. The daily cryptenamine dose was distributed so that the medium dose was taken after breakfast, the minimum dose at 2 p.m., and the maximum dose at bedtime. 2. (2) Oral cryptenamine appeared to be a moderately potent antihypertensive agent when used as the sole mode of therapy on a long term basis. Sixty-eight per cent of the patients so treated reported no side reactions; in the remainder, gastrointestinal symptoms were mild and transitory. Emesis, previously reported as infrequent with cryptenamine therapy, occurred in one patient and was not a limiting factor in continuing treatment. 3. (3) The addition of reserpine, a rauwolfia alkaloid, to the basic cryptenamine therapy of 17 patients enhanced the depressor response to the latter and ameliorated side effects. In this group receiving combination therapy the most notable side-effect was a syndrome attributed to excessive loss of salt in the sweat during periods of high environmental heat and humidity. 4. (4) These data suggest that cryptenamine, alone or with reserpine, has value in the office management of the patient with arterial hypertension over prolonged periods. Clinical and laboratory observations appear to indicate that this therapy may be most effective in the hypertensive individual with cardiac and retinal area involvement and with relatively intact renal function.