Abstract

To the Editor:

Having had hypertension since the age of 29 years (I am now 59), I was interested to read your editorial on hypertension treatment in the Southern Medical Journal¹ but disappointed at the implication that modern drugs (which are definitely great pharmacologic advances) have far fewer sided effects than, for example, reserpine and clonidine hydrochloride. Here is a contrary view from a hypertensive man whose life has probably been prolonged by drugs but who has experienced the many side effects of modern drugs. My personal experience in taking angiotensin-converting enzyme (ACE) inhibitors, calcium channel blockers, α- and β-blockers, and so forth has shown that the combination of 0.05 mg/d reserpine, 2.5 mg/d clopamide (a diuretic), and low-dose (5 mg/d) lisinopril has far fewer side effects, including effects on potency, than the newer, so-called wonder drugs. The hype about modern drugs has overstated their so-called benign side effect profile (the pharmacologic literature shows that the modern drugs have many side effects that make patients feel ill and sometimes actually make them ill), unfortunately giving the older drugs a bad name. Regrettably, reserpine and clopamide are not now available in Canada, where I live. Even chlorthalidone is not easy to get, and I have a far worse skin reaction to hydrochlorothiazide than to chlorthalidone. I am therefore unconvinced by glowing reports of safe drugs with essentially no side effects. The strong marketing of drugs has done wonders for their image but has denigrated patients’ complaints and observations, so that often a patient's comments will be labeled as “psychologic” and dismissed.