medigraphic.com

2000, Number 6

<< Back Next >>

Arch Cardiol Mex 2000; 70 (6)

Comparative study between bisoprolol and metoprolol/hydrochlorothiazide as anti-hypertensive therapy.

Unzueta MA, Unzueta A, Ordóñez TG, Villasis KMA, Cocoletzi LJ, Medina SR

Language: Spanish
References: 25
Page: 589-595
PDF size: 100.21 Kb.


ABSTRACT

The main objective of this research was to compare the efficacy and security of bisoprolol (B), a new cardioselective beta-blocker, that does not have intrinsic sympathomimetic activity, and metoprol associated to hydrochlorothiazide (HCTZ), in the treatment of patients with mild to moderate hypertension. Sixty-two hypertensive patients (47 females and 15 males) aged 20 to 70 years (mean 52.5 ± 10.4) were included in a double-blind, placebo controlled and randomized clinical trial. After a two-weeks wash out period and a similar placebo phase, patients were randomly assigned to receive either a once-daily dosing of B (10 mg) with 6.25 mg of HCTZ, or M (100 mg) plus 6.25 mg of HCTZ during four-weeks. If there was no reduction below 90 mmHg at the end of this period, the dosing of either beta-blocker was doubled. After eight weeks of treatment, the mean decreases in systolic/diastolic blood pressures from baseline were 31.8/21.2 and 28.0/20.6 mmHg for B/HCTZ and M/HCTZ, respectively (p ‹ 0.0001). There were no clinically significant changes from baseline in laboratory parameters in either group. Reduction in blood pressure with B/HCTZ is associated with adverse events and metabolic changes similar to those observed with other antihypertensive drugs.


REFERENCES

  1. Dustan HP, Kaplan LR, Curry CL, De Leon Jr AC, Douglas FL, Frishman W: Report of the Task Force on the availability cardiovascular drugs in the medically indigent. Circulation 1992; 85(2): 849-860.

  2. Systolic hypertension elderly program. Prevention of stroke by antihypertensive drug treatment in older persons with isolated systolic hypertension. JAMA 1991; 265(24): 3255-3264.

  3. The Joint National Committee: The sixth report of the Joint National Committee on prevention, detection, evaluation and treatment of high blood pressure. Arch Intern Med 1997; 157: 2413-2444.

  4. Collins R, Peto R, MacMahon S, Hebert P, Flebach NH, Eberlein KA: Blood pressure, stroke and coronary heart disease. Part 2, short-term reduction in blood pressure: overview of randowized drug trials and their epidemiologic context. Lancet 1990; 335: 827-838.

  5. Daños a la salud. Sistema Nacional de Salud. Boletín de información estadística 1991 (num. 11). Secretaría de Salud.

  6. Encuesta Nacional de Enfermedades Crónicas. Dirección General de Epidemiología. Secretaría de Salud, Instituto Nacional de la Nutrición SZ, 1993.

  7. Trials of hypertension prevention collaborative research group. The effects of nonpharmacologic interventions on blood pressure of persons with high normal levels. Results of the trials of hypertension prevention, phase I. JAMA 1992; 267: 1213-1220.

  8. Working group on management of patients with hypertension and high blood cholesterol. National education program working group report on the management of patients with hypertension and high blood cholesterol. Ann Intern Med 1991; 114: 224-237.

  9. Lancaster SG, Sorkin EM: Bisoprolol. A preliminary review of its pharmacodynamic and pharmacokinetic properties and therapeutic efficacy in hypertension and angina pectoris. Drugs 1988; 36: 256-285.

  10. Leopold G, Pabst J, Ungethum W: Basic pharmacokineties of bisoprolol, a new highly beta selective adrenoceptor antagonist. Br J Clin Pharmacol 1986; 22: 616-621.

  11. Lewin AJ, Lueg MC, Targum S, Cardenas P: A clinical trial evaluating the 24-hour effects of bisoprolol/hydrochlorotiazide 5 mg/6.25 mg combination in patients with mild to moderate hypertension. Clin Cardiol 1993; 16: 732-736.

  12. Neutel JM, Smith DH, Ram VS, Lefkowitz MP, Kazempour MK, Weber MA: Comparison of bisoprolol with atenolol for systemic hypertension in four groups (young, old, black and nonblack) using ambulatory blood pressure monitoring. Bisoprolol investigators group. Am J Cardiol 1993; 72(1): 41-46.

  13. Nadelman J, Frishman W. Clinical use of beta adrenoceptor blockade in systemic hypertension. Drugs 1990; 39(6): 862-876.

  14. Lewis R, Maclean D, Ioannides C, Jhonston A, McDevitt DG: A comparison of bisoprolol and atenolol in treatment of mild to moderate hypertension. Br J Clin Pharmacol 1988; 26(1): 53-59.

  15. Breed JG, Ciamricotti R, Tromp GP, Valster FA, Lageweg E, Van Bortel LM. Quality o life perception during antihypertensive treatment: a comparative study of bisoprolol and enalapril. J cardiovasc Pharmacol 1992; 20(5): 750-755.

  16. American Society of Hypertension. Recommendations for routine blood pressure measurement by indirect cuff sphygmomanometry. Am J Hypertens 1992; 5: 207-9.

  17. Prisant LM, Weir MR, Papademetriou V, Weber MA, Adegbile IA, Alemayehu D, et al: Low-dose drug combination therapy: An alternative firts-line approach to hypertension treatment. Am Heart J 1995; 130: 359-66.

  18. Weir MR, Prisant LM, Papademetriou V, Weber MA, Adegbile IA, Alemayehu D, et al: Antihypertensive therapy and quality of life. Influence of blood pressure reduction, adverse events, and prior antihypertensive therapy. Am J Hypertens 1996; 9: 854-859.

  19. Papademetriou V, Prisant LM, Neutel JM, Weir MR: Efficacy of low dose combination of bisoprolol/hydrochlorotiazide compared with amlodipine and enalapril in men and women with essential hypertension. Am J Cardiol 1998; 81: 1363-1365.

  20. Frishman WH, Burris JF, Mroczec WJ, Weir MR, Alemayehu D, Simon JS, et al: First-line therapy option with low-dose bisoprolol fumarate and low-dose hydrochlorotiazide in patients with stage I and stage II systemic hypertension. J Clin Pharmacol 1994; 35: 182-8.

  21. Bonelli J, Staribacher H: Haemodynamic effects of bisoprolol in patients with coronary heart disease: influence of various bisoprolol plasma concentrations. J Cardiovasc Pharmacol 1986: 8(suppl. 11): S83-S86.

  22. Massie BM, Amidon TM: Coronary Heart disease. In Tierney Jr. LM, McPhee SJ, Papadakis MA. Current medical diagnosis & treatment. 38 th Edition. Connecticut, Apleton & Lange. A Simon & Schuster Company, 1999; 358-368.

  23. Buhler FR, Berglund G, Anderson OK, Bruner HR, Scherrer V, van Brummelen P, et al: Double-blind comparison of cardioselective betablockers bisoprolol and atenolol in Hypertension: the bisoprolol international multicenter study (BIMS). J Cardiovasc Pharmacol 1986; 8 (suppl. 11): S122-S127.

  24. Lithell H, Weiner L, Selinus I, Vessby B: A comparison of the effects of bisoprolol and atenolol on lipoprotein concentrations and blood pressure. J Cardiovasc Pharmacol 1986; 8 (suppl. 11) S128-S133.

  25. Bakris GL, Frohlich ED: The evolution of antihypertensive therapy: An overiew of four decades of experence. J Am Coll Cardiol 1989; 14: 1595-1608.




2020     |     www.medigraphic.com