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Double-blind comparison of metoprolol, alprenolol, and oxprenolol in hypertension

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Summary

A double-blind comparison of the β-blockers metoprolol, alprenolol and oxprenolol was carried out to evaluate their antihypertensive effect and tolerability. 105 patients with previously untreated hypertension entered the trial and 71 completed it. Side-effects were infrequent and were never the reason for drop-out. All three drugs caused a statistically significant reduction in blood-pressure at the lower of the two doses used during a dose-finding period. At the higher dose employed in this period, metoprolol caused a significantly greater reduction in diastolic blood-pressure than did alprenolol or oxprenolol. All three drugs caused a significant reduction in heart rate. During the follow-up period, the β-blockers were supplemented if necessary with hydrochlorothiazide. This was required less frequently in the metoprolol group than in the other two groups.

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References

  • Åblad, B., Borg, K.-O., Carlsson, E., Ek, L., Johnsson, G., Malmfors, T., Regårdh, C.-G.: A survey of the pharmacological properties of metoprolol in animals and man. Acta Pharmacol. Toxicol.36, Suppl. V, 7 (1975)

    Google Scholar 

  • Åblad, B., Ljung, B., Sannerstedt, R.: Haemodynamic effects of β-adrenoreceptor blockers in hypertension. Drugs11, Suppl. 1, 127–134 (1976)

    Google Scholar 

  • Ames, R. P., Hill, P.: Increase in serum-lipids during treatment of hypertension with chlorthalidone. Lancet1976a/I, 721

    Google Scholar 

  • Ames, R. P., Hill, P.: Elevation of serum lipid levels during diuretic therapy of hypertension. Am. J. Med.61, 748 (1976b)

    Google Scholar 

  • Angervall, G., Bystedt, U.: The effect of alprenolol and alprenolol in combination with saluretics in hypertension. Acta Med. Scand.554, 39 (1974)

    Google Scholar 

  • Arnesen, E.: Comparative study of the blood-pressure-lowering effect of combined therapy with chlorthalidone and metoprolol or alfa-methyldopa, judged by self-monitoring of blood pressure. Curr. Ther. Res.24, 889 (1978)

    Google Scholar 

  • Baekeland, F., Lundwall, L.: Dropping out of treatment. A Critical Review. Psychol. Bull.82, 738 (1975)

    Google Scholar 

  • Barrit, D. W., Marshall, A. J., Heaton, S.: Comparison of oxprenolol and methyldopa in hypertension. Lancet1976/I, 503

    Google Scholar 

  • Bengtsson, C.: Comparison between alprenolol and chlorthalidone as antihypertensive agents. Acta Med. Scand.191, 433 (1972)

    Google Scholar 

  • Bengtsson, C.: Comparison between metoprolol and propranolol as antihypertensive agents. A double-blind cross-over study. Acta Med. Scand.199, 71 (1976)

    Google Scholar 

  • Bergstrand, R. H., Vedin, J. A., Wilhelmsson, C. E., Berglund, G.: Comparative study of metoprolol and alpha-methyldopa in untreated essential hypertension. Eur. J. Clin. Pharmacol.10, 375 (1976)

    Google Scholar 

  • Bloem, T. J. J. M., Disch, R. P., Lindner, P. C. J. M., Kerkhof, J. V. D.: Antihypertensive effects of metoprolol and a fixed-ratio combination of metoprolol and hydrochlorothiazide given once daily. Curr. Ther. Res.24, 26 (1978)

    Google Scholar 

  • Caldwell, J., Cobb, S., Dowling, M., Jongh, D.: The drop-out problem in antihypertensive treatment. A pilot study of social and emotional factors influencing a patient's ability to follow antihypertensive treatment. J. Chronic Dis.22, 579 (1970)

    Google Scholar 

  • Castenfors, J., Johnsson, H., Orö, L.: Effect of alprenolol on blood pressure and plasma renin activity in hypertensive patients. Acta Med. Scand.193, 189 (1973)

    Google Scholar 

  • Davies, R., Payne, N. N., Slater, J. D. H.: Beta adrenergic blockade and diuretic therapy in benign essential hypertension: A dynamic assessment. Am. J. Cardiol.37, 637 (1976)

    Google Scholar 

  • Day, J., Simpson, N., Metcalfe, J., Page, R.: Metabolic consequences of atenolol and propranolol in treatment of essential hypertension. Br. Med. J.1979/I, 123

    Google Scholar 

  • Forrest, W. A.: Oxprenolol in hypertension: A report on 2770 patients in general practice originally treated with methyldopa. Scott. Med. J.21, 28 (1976)

    Google Scholar 

  • Gibson, D. G.: Pharmacodynamic properties of Beta adrenergic receptor blocking drugs in Man. Drugs7, 8 (1974)

    Google Scholar 

  • Gordon, I., Kannel, W. B.: Predisposition to atherosclerosis in the head, heart and legs. The Framingham study. J. Am. Med. Assoc.221, 661 (1972)

    Google Scholar 

  • Helgeland, A., Hjermann, I., Holme, I., Leren, P.: Serum triglycerides and serum uric acid in untreated and thiazidetreated patients with mild hypertension. Am. J. Med.64, 34 (1978)

    Google Scholar 

  • Van Herwaarden, C. L. A., Fennis, J. F. M., Binkhorst, R. A., Van't Laar, A.: Haemodynamic effects of adrenaline during treatment of hypertensive patients with propranolol and metoprolol. Eur. J. Clin. Pharmacol.12, 397 (1977)

    Google Scholar 

  • Jäättelä, A., Pyörälä, K.: A controlled study on the antihypertensive effect of a new beta-adrenergic receptor blocking drug, metoprolol, in combination with chlorthalidone. Br. J. Clin. Pharmacol.3, 655 (1976)

    Google Scholar 

  • Johnson, B., Bye, C., Labrooy, J. et al.: The relation of antihypertensive treatment to plasma lipids and other vascular risk factors in hypertensives. Clin. Sci. Mol. Med.49, 9 (1974)

    Google Scholar 

  • Lederballe Pedersen, O.: Comparison of metoprolol and hydrochlorothiazide as antihypertensive agents. Eur. J. Clin. Pharmacol.10, 381 (1976)

    Google Scholar 

  • Nilsson, A., Hansson, B.-G., Hökfelt, B.: Beta-blockers and lipid metabolism. Br. Med. J.1977/III, 126

    Google Scholar 

  • Oh, V. M.-S., Kaye, C. M., Turner, P., Whitmarsh, V. B.: An oral study of cardioselective and non-cardioselective beta-blockers using an exercise technique. In: Topics in cardiovascular disease. Judd, L. (ed.), pp. 167–177. Horsham: CIBA Laboratories 1977

    Google Scholar 

  • Shaw, J., England, J., Hua, A.: Beta-blockers and plasma triglycerides. Br. Med. J.1978/I, 986

    Google Scholar 

  • Thiringer, G., Svedmyr, N.: Interaction of orally administered metoprolol, practolol and propranolol with isoprenaline in asthmatics. Eur. J. Clin. Pharmacol.10, 163 (1976)

    Google Scholar 

  • Tuomilehto, J.: Feasibility of the community programme for control of hypertension. A part of the North Karelia project. Publications of the University of Kuopio, Community-Health-series A. 2 (1975)

  • Tuomilehto, J., Pohjola, M.: A comparison between metoprolol and pindolol in the treatment of essential hypertension. Ann. Clin. Res.10, 24–29 (1978)

    Google Scholar 

  • Tuomilehto, J., Puska, P., Mustaniemi, H.: A comparative study of alprenolol and α-methyldopa respectively in combination with chlorthalidone in hypertension. Acta. Med. Scand., Suppl.554, 47–54 (1974)

    Google Scholar 

  • Tuomilehto, J., Puska, P., Nissinen, A.: Hypertension programme of the North Karelia project. Scand. J. Soc. Med.4, 67 (1976)

    Google Scholar 

  • Vedin, J. A., Wilhelmsson, C.-E., Werkö, L.: Comparative study of alprenolol and methyldopa in previously untreated essential hypertension. Br. Heart J.35, 1285 (1973)

    Google Scholar 

  • Veterans Administration Study Group on Antihypertensive Agent: Effect of treatment on morbidity in hypertension. Results in patients with diastolic blood pressures averaging 115 through 129 mmHg. J. Am. Med. Assoc.202, 116 (1967)

    Google Scholar 

  • Waal-Manning, H. J.: Metabolic effects of β-adrenoreceptor blockers. Drugs11, Suppl. 1, 121 (1976)

    Google Scholar 

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Tuomilehto, J., Nissinen, A. Double-blind comparison of metoprolol, alprenolol, and oxprenolol in hypertension. Eur J Clin Pharmacol 16, 369–374 (1979). https://doi.org/10.1007/BF00568195

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