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.
Similar content being viewed by others
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)
Åblad, B., Ljung, B., Sannerstedt, R.: Haemodynamic effects of β-adrenoreceptor blockers in hypertension. Drugs11, Suppl. 1, 127–134 (1976)
Ames, R. P., Hill, P.: Increase in serum-lipids during treatment of hypertension with chlorthalidone. Lancet1976a/I, 721
Ames, R. P., Hill, P.: Elevation of serum lipid levels during diuretic therapy of hypertension. Am. J. Med.61, 748 (1976b)
Angervall, G., Bystedt, U.: The effect of alprenolol and alprenolol in combination with saluretics in hypertension. Acta Med. Scand.554, 39 (1974)
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)
Baekeland, F., Lundwall, L.: Dropping out of treatment. A Critical Review. Psychol. Bull.82, 738 (1975)
Barrit, D. W., Marshall, A. J., Heaton, S.: Comparison of oxprenolol and methyldopa in hypertension. Lancet1976/I, 503
Bengtsson, C.: Comparison between alprenolol and chlorthalidone as antihypertensive agents. Acta Med. Scand.191, 433 (1972)
Bengtsson, C.: Comparison between metoprolol and propranolol as antihypertensive agents. A double-blind cross-over study. Acta Med. Scand.199, 71 (1976)
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)
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)
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)
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)
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)
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
Forrest, W. A.: Oxprenolol in hypertension: A report on 2770 patients in general practice originally treated with methyldopa. Scott. Med. J.21, 28 (1976)
Gibson, D. G.: Pharmacodynamic properties of Beta adrenergic receptor blocking drugs in Man. Drugs7, 8 (1974)
Gordon, I., Kannel, W. B.: Predisposition to atherosclerosis in the head, heart and legs. The Framingham study. J. Am. Med. Assoc.221, 661 (1972)
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)
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)
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)
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)
Lederballe Pedersen, O.: Comparison of metoprolol and hydrochlorothiazide as antihypertensive agents. Eur. J. Clin. Pharmacol.10, 381 (1976)
Nilsson, A., Hansson, B.-G., Hökfelt, B.: Beta-blockers and lipid metabolism. Br. Med. J.1977/III, 126
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
Shaw, J., England, J., Hua, A.: Beta-blockers and plasma triglycerides. Br. Med. J.1978/I, 986
Thiringer, G., Svedmyr, N.: Interaction of orally administered metoprolol, practolol and propranolol with isoprenaline in asthmatics. Eur. J. Clin. Pharmacol.10, 163 (1976)
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)
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)
Tuomilehto, J., Puska, P., Nissinen, A.: Hypertension programme of the North Karelia project. Scand. J. Soc. Med.4, 67 (1976)
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)
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)
Waal-Manning, H. J.: Metabolic effects of β-adrenoreceptor blockers. Drugs11, Suppl. 1, 121 (1976)
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
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
Received:
Revised:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00568195