Nialamide in the treatment of essential hypertension

The antihypertensive effectiveness of the monoamine oxidase (MAO) inhibitor, nialamide, was investigated. When nialamide was administered in relatively high dosage (225 mg. daily), 44 per cent of the subjects obtained a significant postural reduction of blood pressure; however, when the drug was used in combination with hydrochlorothiazide, 65 per cent of the group had a significant fall of blood pressure. In the supine position, a significant reduction of blood pressure was noted less often, in 20 and 18 per cent of the two groups, respectively. The incidence of side effects encountered was low and there were no instances of clinical hepatotoxicity.

The mechanism of hypotensive action of the MAO inhibitors is still undetermined. The various speculative mechanisms are discussed. It is suggested that these drugs may ultimately be particularly indicated in the hypertensive subject with complicating coronary artery disease.