Excessive Fall In Blood Pressure Research Articles

Comparison of the effects of veratrum alkaloids and of hexamethonium bromide upon the blood pressure in arterial hypertension

1. 1. In thirty-six patients with arterial hypertension attempts were made to reduce the blood pressure by oral administration of mixed veratrum alkaloids (Anatensol, Vertavis), and in twenty-seven of these continued treatment with hexamethonium bromide was also attempted. 2. 2. Substantial blood pressure reduction without important toxic symptoms was possible in ten of thirty-six patients with mixed veratrum alkaloids and in all of twenty-seven patients with hexamethonium bromide injected subcutaneously. Treatment with the latter was maintained for periods of one to fifteen months. 3. 3. Veratrum alkaloids and hexamethonium bromide resemble each other in that the therapeutic range of dosage is narrow. Graded responses can be obtained with less difficulty using hexamethonium bromide. 4. 4. Continued administration leads to drug toleration with hexamethonium bromide, but little or no toleration develops with mixed veratrum alkaloids. The effective dose of hexamethonium bromide becomes stable after some months, and toleration does not interfere with continued treatment. 5. 5. After hexamethonium bromide blood pressure falls are greatest in the standing, intermediate in the sitting, and least in the lying posture. After veratrum alkaloids postural hypotension is inconspicuous. 6. 6. After hexamethonium bromide the pulse is ordinarily accelerated, but following continued treatment it may be unchanged. After veratrum alkaloids there is bradycardia. 7. 7. The main toxic manifestation of hexamethonium bromide is faintness and lassitude associated with excessive fall of blood pressure; the symptoms are maximal when the blood pressure is at its lowest level. After veratrum alkaloids toxic effects occur while the blood pressure is still falling and may have disappeared before the blood pressure reaches its lowest level.