Methyldopa: an agent for the treatment of older patients with isolated systolic hypertension.

An open-label study was conducted to determine the effectiveness and tolerability of methyldopa in the treatment of 20 older patients (mean age, 67 years) with isolated systolic hypertension. After the two-week control period, during which 25 to 50 mg/day of hydrochlorothiazide was administered, the patients had a mean sitting blood pressure greater than or equal to 160/less than or equal to 95 mmHg. The patients were then treated for up to 16 weeks with a daily regimen of 25 to 50 mg of hydrochlorothiazide and 250 to 1,000 mg of methyldopa. The therapy controlled isolated systolic hypertension without orthostatic hypotension or adverse reactions. Clinically and statistically significant reductions (P generally less than 0.01) in mean sitting and standing systolic blood pressures occurred after as little as two weeks of treatment and were maintained throughout the 16-week study period. The findings suggest that methyldopa is suitable for use among older hypertensive patients.