Key result
Once-daily atenolol, but not metoprolol, reduces exercise HR and BP 24 hours post-dose versus placebo.
Why the study?
Does once daily administration of long-acting or conventional metoprolol maintain 24-hour antihypertensive and beta-blocking effects compared to atenolol in hypertensive patients?
Population
12 hypertensive patients concurrently receiving diuretic therapy
Comparison
Conventional metoprolol 200 mg vs two long-acting metoprolol formulations 200 mg vs atenolol 100 mg vs placebo
Design
Cross-over study
Authors
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May favor atenolol over once-daily metoprolol for sustained control; hypothesis-generating and should not yet alter prescribing in hypertension.
RCT (n=12)
Does once daily administration of long-acting or conventional metoprolol maintain 24-hour antihypertensive and beta-blocking effects compared to atenolol in hypertensive patients?
p-value: p=<0.001
Once daily metoprolol, even in long-acting formulations, fails to maintain adequate 24-hour antihypertensive efficacy compared to atenolol and should be prescribed twice daily.
Silas et al. (1985) conducted an RCT in Hypertension (n=12). Metoprolol (conventional and long-acting formulations) and atenolol vs. Placebo was evaluated on Reduction in exercise heart rate and blood pressure 24 hours after dosing (p=<0.001). Once daily atenolol 100 mg, but not metoprolol 200 mg, significantly reduced exercise heart rate (P<0.001) and blood pressure (P<0.02) 24 hours after dosing compared with placebo.
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