Vasodilator Drugs in the Treatment of Hypertension

Jan Koch-Weser, MD
Arch Intern Med. 1974;133(6):1017-1027. doi:10.1001/archinte.1974.00320180135012.
Text Size: A A A
Published online

Treatment with vasodilating drugs specifically reverses the major hemodynamic abnormality of primary hypertension. Hypotensive effectiveness of vasodilators is limited by three responses of hypertensives to vasodilation-induced blood pressure reduction, including reflex increases in sympathetic activity that raise cardiac output, augmentation of plasma renin activity, and sodium retention with plasma volume expansion. Concomitant administration of propranolol suppresses the first and second responses, and diuretics prevent the third. In treating chronic hypertension, vasodilators should be coadministered with both drugs. Potentiated in this fashion, well-tolerated doses of hydralazine (200 mg/day) can normalize the hemodynamics of most hypertensives. Guancydine and, particularly, minoxidil are promising antihypertensive vasodilators but remain in the investigative stages. Nitroprusside and diazoxide are powerful intravenous vasodilators and are effective for hypertensive emergencies. They differ in time course of action and in effect on cardiac output.


Sign In to Access Full Content

Don't have Access?

Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more

Subscribe for full-text access to content from 1998 forward and a host of useful features

Activate your current subscription (AMA members and current subscribers)

Purchase Online Access to this article for 24 hours





Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).
Submit a Comment


Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

Related Content

Customize your page view by dragging & repositioning the boxes below.