Transdermal therapy of arterial hypertension: a new approach in the management of hypertensive patients
Ambrosioni, E.
Annali Italiani di Medicina Interna Organo Ufficiale Della Societa Italiana di Medicina Interna 9 Suppl: 54s-57s
1994
ISSN/ISBN: 0393-9340 PMID: 7857759 Document Number: 431284
Hypertension remains one of the most important cardiovascular risk factors: the excess of mortality in hypertensive patients is due in 70% of cases to mild hypertension. A therapy able to reduce this risk has to be free from any even negligible negative effect, to control blood pressure 24 hours over 24 hours and to reduce the blood pressure variability to a minimum. The transdermal preparation of clonidine (TTS) permits a continuous and constant administration of the drug by applying a patch on the skin once a week. The serum concentration of clonidine reaches the steady-state in 2-4 days and it remains constant during a 7-day period and at the time of the change of the patch. Blood pressure reduction is completed in 1-2 weeks without any interference with the orthostatic control and with the haemodynamic response to exercise. After discontinuation of treatment there is neither a blood pressure nor a plasma catecholamine rebound: both indexes return to pre-treatment values after 3 to 5 days. Systemic side effects of TTS are markedly reduced as compared to oral preparation due to the absence of peak plasma concentration. Cutaneous reactions in the site of application of the patch are present in 14-16% of patients. The total percentage of both systemic and cutaneous side effects is around 22%. In conclusion, TTS is a safe and efficacious therapeutic means to reach a constant blood pressure control in hypertension.