ELIZABETH YOUNG, M.D.; BARBARA A. LEVEY, M.D.; ALVIN P. SHAPIRO, M.D.
YOUNG E, LEVEY BA, SHAPIRO AP. Paradoxical Hypertension from Clonidine. Ann Intern Med. 1984;101:282-283. doi: 10.7326/0003-4819-101-2-282_2
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Published: Ann Intern Med. 1984;101(2):282-283.
To the editor: Clonidine is an alpha-receptor agonist that has both central and peripheral stimulating effects. Its central agonism produces vasodilation that predominates over peripheral vasoconstriction and results in lower blood pressures in hypertensive patients. However, in patients with idiopathic orthostatic hypotension and impaired central sympathetic outflow, the peripheral vasconstrictor effects of Clonidine have recently been noted to predominate, and the drug thus can be used to treat this condition (1).
Hypertensive diabetic patients often have orthostatic hypotension from autonomic nervous system neuropathy, making their hypertension particularly difficult to treat. We recently saw such a patient who was given Clonidine
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