January 1, 1998Cardiology
A Comparison of the Effects of Mibefradil and Atenolol on Regression of Left Ventricular Hypertrophy in Hypertensive Patients
Key result
Mibefradil reduced left ventricular mass index by 11.1% compared to 9.1% with atenolol, a difference that was not statistically significant, but mibefradil had fewer adverse events.
Why the study?
Does mibefradil improve regression of left ventricular hypertrophy compared to atenolol in patients with mild-to-moderate hypertension?
Population
n=66 patients with mild-to-moderate hypertension and left ventricular hypertrophy
Comparison
Mibefradil 50 mg initially for 4 weeks… vs Atenolol 50 mg initially for 4 weeks, increased…
Design
RCT, randomized, parallel-group, double-blind
Follow-up
24 weeks
Authors
Discussion
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Implication
Mibefradil matches atenolol for LV mass regression with fewer adverse events; confirms comparable efficacy while favoring better tolerability in hypertension.
Study Design
Type
RCT (n=66)
Blinding
Double-blind
Randomization
parallel-group
Multicenter
Yes
Structured PICO
Does mibefradil improve regression of left ventricular hypertrophy compared to atenolol in patients with mild-to-moderate hypertension?
P
Population
66 patients with mild-to-moderate hypertension and left ventricular hypertrophy, treated for 24 weeks.
I
Intervention
Mibefradil 50 mg initially for 4 weeks, increased to 100 mg/day if blood pressure not normalized to <= 90 mm Hg, with optional addition of hydrochlorothiazide 25 mg, for a total of 24 weeks
C
Comparator
Atenolol 50 mg initially for 4 weeks, increased to 100 mg/day if blood pressure not normalized to <= 90 mm Hg, with optional addition of hydrochlorothiazide 25 mg, for a total of 24 weeks
O
Outcome
Regression of left ventricular (LV) hypertrophy (change in LV mass index) assessed by echocardiography at 24 weekssurrogate
Main Result
Absolute Event Rate: 11.1% vs 9.1%
p-value: p=not significant
Mibefradil and atenolol are equally effective in reducing left ventricular mass index and blood pressure in hypertensive patients, though mibefradil may be associated with fewer drug-related adverse events.
Cite This Study
Höglund et al. (1998) conducted an RCT in mild-to-moderate hypertension and left ventricular hypertrophy (n=66). Mibefradil vs. Atenolol was evaluated on Decrease from baseline in left ventricular mass index (p=not significant). Mibefradil reduced left ventricular mass index by 11.1% compared to 9.1% with atenolol, a difference that was not statistically significant, but mibefradil had fewer adverse events.