Clonidine Blood Pressure and Heart Rate Holding Parameters

Mechanism and Effects on BP and HR

• The American College of Cardiology recommends holding clonidine if systolic blood pressure is <90 mmHg, diastolic blood pressure is <60 mmHg, or heart rate is <50 beats per minute to prevent adverse cardiovascular events 1, 2, 3

Specific Holding Parameters

• The American College of Cardiology suggests holding clonidine if systolic BP <90 mmHg 1, 3
• The American College of Cardiology suggests holding clonidine if diastolic BP <60 mmHg 1, 3
• Consider holding clonidine if patient shows signs of orthostatic hypotension, especially in older adults 4, 5
• The American College of Cardiology recommends holding clonidine if heart rate <50 beats per minute 2, 4

Special Considerations

• The American College of Cardiology warns that abrupt discontinuation of clonidine may induce hypertensive crisis 1, 2, 3
• If clonidine must be discontinued, it should be tapered gradually to avoid rebound hypertension 4
• The risk of rebound hypertension is highest when clonidine is suddenly stopped after prolonged use 5
• Check BP and HR before each dose 4
• Monitor for orthostatic changes, especially in elderly patients 6
• For patients with coronary artery disease and hypertension, lowering BP too rapidly may exacerbate myocardial ischemia 6