A comparison between metoprolol, alprenolol and oxprenolol in the treatment of hypertension
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A double-blind study over 12 months
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By Jaakko Tuomilehto North Karelia Project University of Kuopio Finland
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Introduction: Metoprolol is a D1-selective B-blocker devoid of intrinsic stimulating activity (I.S.A.) and alprenolol and oxprenolol are two non-selective B-blockers with I.S.A. (1). With the background
of these pharmacological differences we undertook the following comparative study between the three P-blockers in order to evaluate their antihypertensive effect and tolerability.
Patients and methods 106 patients with a newly discovered and previously untreated
hypertension were included into the study.
There were 9 4 males
and 12 females with a mean age of 4 2 years, range 16 All patients belonged to WHO-stage I or 11.
-
68 years.
Patients with AV-block,
chronic obstructive lung diseases, cardiac decompensation and insulin treated diabetes mellitus, were primarily excluded from this investigation. The design of the study is given in figure 1. After the initial six weeks run-in period on placebo patients with a sitting BP k 1 6 0 / 9 6 mm Hg were randomly allocated to one of three parallel groups, to be treated with either metoprolol, alprenolol or oxprenolol. 74
During the first four weeks of active therapy the doses of metoprolol, alprenolol and oxprenolol were 100 mg b.i.d., 200 mg b.i.d.
and 80 mg b.i.d. respectively.
During the
following eight weeks all patients received respective B-blocker in the double dose. These doses of the three B-blockers were regarded as equipotent with regard to reduction of exercise induced tachycardia and are the doses generally recommended in the treatment of hypertension (2).
After this "dose-finding
period" the patients were followed up for another 38 weeks with control visits after 12 and 26 weeks respectively.
During this
"follow-up period" the patients were maintained on the lowest dose giving normotension i.e. a blood pressure
-
A double-blind study over 12 months
-
By Jaakko Tuomilehto North Karelia Project University of Kuopio Finland
-
-
Introduction: Metoprolol is a D1-selective B-blocker devoid of intrinsic stimulating activity (I.S.A.) and alprenolol and oxprenolol are two non-selective B-blockers with I.S.A. (1). With the background
of these pharmacological differences we undertook the following comparative study between the three P-blockers in order to evaluate their antihypertensive effect and tolerability.
Patients and methods 106 patients with a newly discovered and previously untreated
hypertension were included into the study.
There were 9 4 males
and 12 females with a mean age of 4 2 years, range 16 All patients belonged to WHO-stage I or 11.
-
68 years.
Patients with AV-block,
chronic obstructive lung diseases, cardiac decompensation and insulin treated diabetes mellitus, were primarily excluded from this investigation. The design of the study is given in figure 1. After the initial six weeks run-in period on placebo patients with a sitting BP k 1 6 0 / 9 6 mm Hg were randomly allocated to one of three parallel groups, to be treated with either metoprolol, alprenolol or oxprenolol. 74
During the first four weeks of active therapy the doses of metoprolol, alprenolol and oxprenolol were 100 mg b.i.d., 200 mg b.i.d.
and 80 mg b.i.d. respectively.
During the
following eight weeks all patients received respective B-blocker in the double dose. These doses of the three B-blockers were regarded as equipotent with regard to reduction of exercise induced tachycardia and are the doses generally recommended in the treatment of hypertension (2).
After this "dose-finding
period" the patients were followed up for another 38 weeks with control visits after 12 and 26 weeks respectively.
During this
"follow-up period" the patients were maintained on the lowest dose giving normotension i.e. a blood pressure
