Clonazepam in the treatment of labile arterial hypertension in the elderly

Aim. To investigate effectiveness of clonazepam and its influence on autono mic function. Material and methods. 56 patients with LHE aged 67.0+6.3 years were examine d. 50 of them were treated with clonazepam in daily dose 1-2 mg. Their resu lts were compared with age and sex matched normotensive persons. The routin e clinical examination, regular measurement of blood pressure (BP), psychol ogical tests, investigation of heart rate variability and evoked cutaneous sympathetic potentials (ECSP) were made. These tests were performed before and after treatment with clonazepam. Results. Clonazepam significantly reduced fluctuations of BP in 82.0% of pa tients with LHE: the fluctuation range of systolic BP was reduced 2 times, diastolic BP-1.6. At the same time clonazepam diminished the level of anxie ty, heart rate variability with increasing normalized VLF (central influenc e) and lowering LF and HF (segmental sympathetic and, parasympathetic influ ences). ECSP were characterized by slowing sympathetic conduction and reduc tion of ECSP amplitude. Conclusion. Clonazepam, by changing autonomic properties, leads to stabiliz ation of blood pressure in most patients with LHE. It is recommended to use clonazepam in daily dose 1-2 mg in combination with conventional antihyper tensive medications for prevention of excessive fluctuation of BP in patien ts with LHE.