Key result
Once-daily administration of atenolol, metoprolol, pindolol, and slow-release propranolol significantly reduced blood pressure at 24 hours, but showed considerable differences in hourly control.
Why the study?
Does once-daily administration of atenolol, metoprolol, pindolol, or slow-release propranolol equally reduce 24-hour ambulatory blood pressure in patients with essential hypertension?
RCT (n=34)
Double-blind
randomized
Does once-daily administration of atenolol, metoprolol, pindolol, or slow-release propranolol equally reduce 24-hour ambulatory blood pressure in patients with essential hypertension?
Not all conventional beta-blockers provide equal 24-hour blood pressure control when administered once daily.
Clinicians should verify 24-hour coverage before once-daily beta-blocker use; extends RCT evidence of substantial hourly differences among agents.
Twenty-four-hour intra-arterial blood pressure recordings were made before and after chronic β-receptor blockade in 34 patients with essential hypertension. 2. Subjects were randomized in double blind fashion to either atenolol, metoprolol, pindolol or slow-release propranolol. 3. Drugs were administered in a once-daily variable dose regimen for a period of 3–8 months (mean 5.0 ± sd 1.4). 4. All four drugs reduced blood pressure significantly 24 h after the last dose but there were considerable differences in control when each intervening hour was assessed separately. 5. Not all β-receptor blockers in conventional formulations are equally effective as antihypertensive agents over 24 h when taken once daily.
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Floras et al. (1982) conducted an RCT in essential hypertension (n=34). atenolol, metoprolol, pindolol, or slow-release propranolol was evaluated on blood pressure 24 h after the last dose. Once-daily administration of atenolol, metoprolol, pindolol, and slow-release propranolol significantly reduced blood pressure at 24 hours, but showed considerable differences in hourly control.
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