Efficacy of slow infusion of diazoxide in the treatment of severe hypertension without organ hypoperfusion

Diazoxide as usually given in a single bolus, may cause precipitous falls in blood pressure (BP) with resultant tissue hypoperfusion. To examine the efficacy and safety of slow infusion, we treated 18 patients with mean initial BP of 220 143 mm Hg by two regimens: group A (nine patients) received 15 mg/minute; group B (nine patients) received 30 mg/minute. The goal of therapy, diastolic BP of 100 to 105 mm Hg, was reached in 16 of the 18 with no immediate drug-related side effects. Infusion time was 38.1 minutes in group A and 20.7 minutes in group B. Slow intravenous infusion of diazoxide appears to be safe and effective treatment for severe hypertension and should replace the rapid bolus technique.