Clonidine in Hypertensive Urgencies-Reply

In Reply.—  The use of oral clonidine loading for hypertensive urgencies would have limited use if clonidine could not serve as a major component of long-term maintenance therapy. After all, the ability to control blood pressure (BP) on a long-term basis is "the test of the pudding."An attempt is commonly made to extrapolate information obtained from safety and efficacy trials using volunteer subjects. Therefore, we purposely enrolled an inception cohort that is comparable with the population of severely hypertensive patients served by Parkland Memorial Hospital's emergency room. We did not exclude patients with a history of noncompliance. Neither did we exclude three patients with chronic alcoholism nor one patient with a history of heroin addiction. No patient merely had clonidine therapy reinstituted.A 55% "dropout" rate had been experienced in a similar population of Parkland patients within six months.¹ In the clonidine loading study, patients were hospitalized and