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Central sympatholytic drugs for the treatment of hypertension: back to the future?

In this issue of the Journal, Esler et al. [1] present a remarkable study on the neurohumoral effects of the sympatholytic agent rilmenidine in hypertensive patients. The authors have treated hypertensive patients with the central sympatholytic agent rilmenidine and with placebo in a double-blind, randomized cross-over trial and measured blood pressure, heart rate and catecholamine spillover. They observed an average systodiastolic blood pressure decrease by 15/7 mmHg with rilmenidine and a reduction in norepinephrine spillover by 35% without affecting epinephrine release.