{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T22:23:41Z","timestamp":1787955821190,"version":"build-2784847793"},"reference-count":29,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2020,3,17]],"date-time":"2020-03-17T00:00:00Z","timestamp":1584403200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01 HL113004"],"award-info":[{"award-number":["R01 HL113004"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["2T32HL007457-36A1"],"award-info":[{"award-number":["2T32HL007457-36A1"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000968","name":"American Heart Association","doi-asserted-by":"publisher","award":["AHA 15SFRN239002"],"award-info":[{"award-number":["AHA 15SFRN239002"]}],"id":[{"id":"10.13039\/100000968","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,8,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>Refractory hypertension (RfHTN), a phenotype of antihypertensive treatment failure, is defined as uncontrolled automated office blood pressure (AOBP) \u2265130\/80 mm Hg and awake ambulatory blood pressure (ABP) \u2265130\/80 mm Hg on \u22655 antihypertensive medications, including chlorthalidone and a mineralocorticoid receptor antagonist. Previous studies suggest that RfHTN is attributable to heightened sympathetic tone. The current study tested whether reserpine, a potent sympatholytic agent, lowers blood pressure (BP) in patients with RfHTN.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>Twenty-one out of 45 consecutive patients with suspected RfHTN were determined to be fully adherent with their antihypertensive regimen. Seven patients agreed to participate in the current clinical trial with reserpine and 6 patients completed the study. Other sympatholytic medications, such as clonidine or guanfacine, were tapered and discontinued before starting reserpine. Reserpine 0.1 mg daily was administered in an open-label fashion for 4 weeks. All patients were evaluated by AOBP and 24-hour ABP at baseline and after 4 weeks of treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Reserpine lowered mean systolic and diastolic AOBP by 29.3 \u00b1 22.2 and 22.0 \u00b1 15.8 mm Hg, respectively. Mean 24-hour systolic and diastolic ABPs were reduced by 21.8 \u00b1 13.4 and 15.3 \u00b1 9.6 mm Hg, mean awake systolic and diastolic ABPs by 23.8 \u00b1 11.8 and 17.8 \u00b1 9.2 mm Hg, and mean asleep systolic and diastolic ABPs by 21.5 \u00b1 11.4 and 13.7 \u00b1 6.4 mm Hg, respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>Reserpine, a potent sympatholytic agent, lowers BP in patients whose BP remained uncontrolled on maximal antihypertensive therapy, lending support to the hypothesis that excess sympathetic output contributes importantly to the development of RfHTN.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ajh\/hpaa042","type":"journal-article","created":{"date-parts":[[2020,3,11]],"date-time":"2020-03-11T16:23:13Z","timestamp":1583943793000},"page":"741-747","source":"Crossref","is-referenced-by-count":28,"title":["Reserpine Substantially 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Alabama,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suzanne","family":"Oparil","sequence":"additional","affiliation":[{"name":"Vascular Biology and Hypertension Program, Department of Medicine, University of Alabama at Birmingham , Birmingham, Alabama,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David A","family":"Calhoun","sequence":"additional","affiliation":[{"name":"Vascular Biology and Hypertension Program, Department of Medicine, University of Alabama at Birmingham , Birmingham, Alabama,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2020,3,17]]},"reference":[{"key":"2026041420043999900_CIT0001","doi-asserted-by":"crossref","first-page":"126","DOI":"10.1161\/HYPERTENSIONAHA.115.05449","article-title":"Refractory hypertension: evidence of heightened sympathetic activity as a cause of antihypertensive treatment 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