A dose of reserpine 0.5 mg/day or greater achieved the SBP effects .
AUTHORS ' CONCLUSIONS Reserpine is effective in reducing SBP roughly to the same degree as other first-line antihypertensive drugs .
BACKGROUND Many antihypertensive agents exist today for the treatment of primary hypertension ( systolic blood pressure ≥ 140 mmHg or diastolic blood pressure ≥ 90 mmHg , or both ) .
R and omised controlled trials ( RCTs ) have been carried out to investigate the evidence for these agents .
There is , for example , strong RCT evidence that thiazides reduce mortality and morbidity .
Some of those trials used reserpine as a second-line therapy .
However , the dose-related blood pressure reduction with this agent is not known .
OBJECTIVES The primary objective of this review was to quantify the dose-related efficacy of reserpine versus placebo or no treatment in reducing systolic blood pressure ( SBP ) or diastolic blood pressure ( DBP ) , or both .
We also aim ed to evaluate the dose-related effects of reserpine  on mean arterial blood pressure ( MAP ) and heart rate ( HR ) , as well as the dose-related effects on withdrawals due to adverse events .
Effect of atenolol and reserpine on selected events in the systolic hypertension in the elderly program (SHEP).
The effect of atenolol and reserpine on incidence of strokes , coronary heart disease ( CHD ) , cardiovascular disease ( CVD ) , and mortality  was assessed in 4736 persons aged 60 years and older with isolated systolic hypertension . Participants were r and omized to either chlorthalidone ( 2371 ) , with step-up to atenolol , or reserpine if needed , or placebo ( 2365 ) . The average baseline SBP/DBP was 170/77 mm Hg . In the active treatment group , step 1 , dose 1 was chlorthalidone , 12.5 mg/day ; dose 2 was 25 mg/day . For step 2 , dose 1 was atenolol 25 mg/day ( or reserpine 0.05 mg/day if atenolol was contraindicated ) ; dose 2 was 50 mg/day ( reserpine , 0.10 mg/day ) . During 4.5 years average follow-up , 32 % ( 757 ) of the active treatment group were on atenolol , with an average exposure of two years and 8 % ( 193 ) were on reserpine with an average exposure of 1.7 years . Overall there were 96 strokes , 140 CHD events and 289 CVD events among the 2365 active group participants . Using time-dependent lifetable regression with adjustment for several variables , the addition of either atenolol or reserpine to chlorthalidone did not substantially alter the risk ratios for chlorthalidone alone . The relative risk for CHD events for atenolol versus no atenolol was 1.04 ( 95 % confidence interval : 0.58 , 1.86 ) and for reserpine versus no reserpine was 0.93 ( 95 % confidence interval : 0.29 , 2.96 ) . The relative risk for atenolol  were 0.84 ( 95 % confidence interval : 0.54 , 1.30 ) for death , 1.34 ( 95 % confidence interval : 0.80 , 2.28 ) for stroke , and 1.07 ( 95 % confidence interval : 0.71 , 1.61 ) for CVD . For reserpine , the corresponding relative risks and confidence intervals were 0.65 ( 0.26 , 1.59 ) for death , 0.27 ( 0.04 , 2.26 ) for stroke , and 0.55 ( 0.20 , 1.49 ) for CVD . Thus , the beneficial effects in several outcomes in Systolic Hypertension in the Elderly Program ( SHEP ) were due to the treatment regimen of lowering blood pressure based on low-dose chlorthalidone ( plus atenolol or reserpine as required to meet blood pressure criteria ) . Additional ( independent ) benefits attributable to atenolol or to reserpine were not identified . However , a greater number of patients might have been necessary to adequately evaluate potential differential effects of these drugs , especially for reserpine
A dose of reserpine 0.5 mg/day or greater achieved the SBP effects .
AUTHORS ' CONCLUSIONS Reserpine is effective in reducing SBP roughly to the same degree as other first-line antihypertensive drugs .
BACKGROUND Many antihypertensive agents exist today for the treatment of primary hypertension ( systolic blood pressure ≥ 140 mmHg or diastolic blood pressure ≥ 90 mmHg , or both ) .
R and omised controlled trials ( RCTs ) have been carried out to investigate the evidence for these agents .
There is , for example , strong RCT evidence that thiazides reduce mortality and morbidity .
Some of those trials used reserpine as a second-line therapy .
However , the dose-related blood pressure reduction with this agent is not known .
OBJECTIVES The primary objective of this review was to quantify the dose-related efficacy of reserpine versus placebo or no treatment in reducing systolic blood pressure ( SBP ) or diastolic blood pressure ( DBP ) , or both .
We also aim ed to evaluate the dose-related effects of reserpine  on mean arterial blood pressure ( MAP ) and heart rate ( HR ) , as well as the dose-related effects on withdrawals due to adverse events .