Methyldopa Supplement for Resistant Essential Hyper tension : A Prospective Randomized Placebo Control Crossover Study

ANAWAT SERMSWAN, MD*, NARTANONG ARCHA WARAK, BEd*

Affiliation : * Cardiology Unit, Department of Medicine, Bangkok Metropolitan Administration Medical College and Vajira Hospital, Bangkok 10300, Thailand.

AbstractBackground : Resistant hypertension is an important public health problem, its prevalence varies between 30 to 50 per cent. However, there is no definite recommendation for the treatment of resistant hypertension (HT).
Materials and Methods : A prospective randomized placebo control crossover study in resistant HT was designed to compare safety and efficacy between methyldopa 250 mg twice daily and placebo using ambulatory blood pressure monitoring.
Results : 87 from 1,112 cases (7.82%) from the hypertension clinic of Vajira Hospital were found to have clinical resistant HT and 40 cases were accepted to enrolled in the study. 23 cases of true resistant HT proceeded to the treatment phase of the study and all of them completed the study. Methyldopa reduced systolic blood pressure (BP) from 153.67 to 135.23 mmHg, or -18.44 mmHg (95% confidence interval 15.13-21.75). Diastolic BP was reduced from 86.42 to 74.90 mmHg, or -11.52 mmHg (95% confidence interval9.41-13.63).
Conclusion :The addition of methyldopa to the optimal medical therapy contributed to the improvement of BP control among patients with resistant HT.

Keywords : Resistant Hypertension, Methyldopa, Ambulatory Blood Pressure Monitoring

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