Slow-Release Oxprenolol Compared with Oxprenolol in Hypertensive Patients: A Multicenter Clinical Trial

1983 ◽  
Vol 17 (1) ◽  
pp. 51-54 ◽  
Author(s):  
Barry J. Materson ◽  
Basil A. Friedman ◽  
Khin Mae Hla ◽  
Barry S. Neidorf ◽  
James M. Gray ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Slow Release ◽  
Blocking Agent ◽  
Intrinsic Sympathomimetic Activity ◽  
Double Blind ◽  
Once Daily ◽  
Washout Phase ◽  
Blood Pressures ◽  
Adrenergic Blocking ◽  
Slow Release Preparation

Oxprenolol (OX) is a nonselective, β-adrenergic blocking agent with intrinsic sympathomimetic activity. We studied 178 patients in five centers to determine whether a polymer-matrix-based, slow-release preparation of oxprenolol (SR-OX) given once daily was as effective as the standard preparation given twice daily for the treatment of patients with mild to moderate hypertension. After a placebo washout phase, patients were treated with OX until blood pressure was controlled. They were then randomized in a double-blind fashion to continue the same dose, given as either OX bid or SR-OX qd with a placebo as the second dose. All patients took hydrochlorothiazide 50–100 mg/d throughout the study. Blood pressure was reduced 23/15 mm Hg ( p < 0.001) and pulse 8 beats/min in the SR-OX group (n = 67) and 24/17 mm Hg ( p < 0.001) and 8 beats/min in the OX group (n = 72) by titrating standard OX. After randomization to SR-OX or OX, there were no further changes over six weeks. Home-determined blood pressures showed no loss of control in the evening. There were no unexpected adverse effects. We conclude that SR-OX given once daily is as effective as OX given twice daily for the treatment of hypertension.

Prazosin and Hydrallazine in the Treatment of Hypertension

1976 ◽  
Vol 51 (s3) ◽  
pp. 617s-619s ◽  
Author(s):  
Priscilla Kincaid-Smith ◽  
A. S. P. Hua ◽  
J. B. Myers ◽  
Ileene Macdonald ◽  
P. Fang
Keyword(s):  
Blood Pressure ◽  
Side Effects ◽  
Diastolic Blood Pressure ◽  
Blocking Agent ◽  
Base Line ◽  
Double Blind ◽  
Supine Diastolic Blood Pressure ◽  
Treatment Of Hypertension ◽  
Blood Pressures

1. Two vasodilators, prazosin and hydrallazine, have been compared in three double-blind cross-over studies designed to test their effect when used in combination with a β-adrenoceptor-blocking agent and a thiazide. 2. Single doses of 3 mg of prazosin or 75 mg of hydrallazine were administered to patients whose blood pressures remained uncontrolled on a thiazide and a β-adrenoceptor-blocking agent. Both agents produced significant falls in systolic and diastolic blood pressure apparent at 1 h. The effects of prazosin persisted for 6–7 h and those of hydrallazine for 4–6 h. Tachycardia was more marked and more prolonged after hydrallazine and continued after the blood pressure had risen to base-line levels or above. 3. In 6 week and 12 week double-blind cross-over studies, mean falls in blood pressure were similar with prazosin and hydrallazine. Similar falls in the supine diastolic blood pressure were achieved with 1 mg of prazosin and 20 mg of hydrallazine, but for a given fall in supine diastolic blood pressure, prazosin produced a significantly lower standing diastolic blood pressure. 4. Severe side effects were more pronounced after hydrallazine, which necessitated withdrawal of seven patients, whereas only one patient on prazosin withdrew from the trial because of side effects.

Effect of Long-Term, Once-Daily Administration of Atenolol, Metoprolol, Pindolol and Slow-Release Propranolol on Ambulatory Blood Pressure and its Variability

1982 ◽  
Vol 63 (s8) ◽  
pp. 459s-460s ◽  
Author(s):  
J. S. Floras ◽  
J. V. Jones ◽  
M. O. Hassan ◽  
P. Sleight
Keyword(s):  
Blood Pressure ◽  
Slow Release ◽  
Antihypertensive Agents ◽  
Double Blind ◽  
Once Daily ◽  
Arterial Blood ◽  
Before And After ◽  
Receptor Blockers ◽  
Β Receptor

1. 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.

scholarly journals Once Daily Beta-Blocker in Hypertension – Oxprenolol Slow-Release

1981 ◽  
Vol 9 (1) ◽  
pp. 6-11
Author(s):  
R D Gordon ◽  
M Ziesak ◽  
W S Rowe ◽  
C R Strakosch ◽  
G Row
Keyword(s):  
Blood Pressure ◽  
Pulse Rate ◽  
Beta Blocker ◽  
Slow Release ◽  
Beta Blockers ◽  
Once Daily ◽  
Treatment Of Hypertension ◽  
Blood Pressures ◽  
Order Of Administration ◽  
At Home

In a within-patient comparison of conventional oxprenolol administered twice daily with slow-release oxprenolol administered once daily in the treatment of hypertension, twenty patients previously responsive to beta-blockers took each formulation for 4 weeks, after wash-out periods off beta-blocker of 2 weeks' duration. The order of administration of the two forms was randomized, and sixteen patients continued medication with cyclopenthiazide 0.5 mg daily. Blood pressure levels at the end of the 4-week treatment periods were compared with levels at the end of the preceding 2-week wash-out periods. Both formulations lowered blood pressure and pulse rate significantly. There was no difference in their effects on pulse rate or on blood pressure, whether measured by the doctors using standard sphygmomanometers or by the hypertension sister using a random-zero sphygmomanometer. In four patients who measured their own blood pressures at home each morning (before medications), afternoon and night, mean levels were similar with the two formulations. Both formulations were very well tolerated.

scholarly journals A randomized trial of the efficacy and safety of azilsartan medoxomil combined with chlorthalidone

2018 ◽  
Vol 19 (3) ◽  
pp. 147032031879500
Author(s):  
Michael A Weber ◽  
Peter Sever ◽  
Attila Juhasz ◽  
Andrew Roberts ◽  
Charlie Cao
Keyword(s):  
Blood Pressure ◽  
Blood Pressure Monitoring ◽  
Plasma Potassium ◽  
Drug Discontinuation ◽  
Efficacy And Safety ◽  
Pressure Monitoring ◽  
Double Blind ◽  
Once Daily ◽  
Blood Pressures ◽  
Azilsartan Medoxomil

Introduction: We measured the effects of azilsartan medoxomil co-administered with chlorthalidone 25 mg in stage 2 hypertension. Methods: Azilsartan medoxomil 40 or 80 mg plus chlorthalidone were compared with placebo plus chlorthalidone once daily in a randomized, double-blind, 6-week trial. The primary endpoint was change from baseline in 24-hour mean systolic blood pressure by ambulatory blood pressure monitoring. Results: Patients ( N=551; mean age 59 years; 51.7% men) were randomly assigned to placebo plus chlorthalidone ( n=184), azilsartan medoxomil 40 mg plus chlorthalidone ( n=185), or azilsartan medoxomil 80 mg plus chlorthalidone ( n=182). Baseline systolic blood pressures were similar among groups. After 6 weeks, least squares mean (standard error) reductions with azilsartan medoxomil 40 mg and 80 mg plus chlorthalidone were similar in magnitude (−31.7 (1.0) and −31.3 (1.0) mmHg, respectively), but greater than chlorthalidone alone (−15.9 (1.0) mmHg). Hypotension and serum creatinine elevations were more frequent with azilsartan medoxomil plus chlorthalidone than chlorthalidone alone (reversed with drug discontinuation). Notably, plasma potassium reduction of 0.43 meq/L with chlorthalidone was attenuated to 0.13 and 0.05 meq/L by azilsartan medoxomil 40 mg and 80 mg, respectively. Conclusion: Azilsartan medoxomil 40 mg or 80 mg plus chlorthalidone 25 mg was significantly more efficacious than chlorthalidone alone in reducing blood pressure and was well tolerated. Clinicaltrial.gov , https://clinicaltrials.gov/ct2/show/NCT00591773 , NCT00591773

Massive Clonidine Ingestion with Hypertension in a 9-Month-Old Infant

PEDIATRICS ◽  
1983 ◽  
Vol 72 (4) ◽  
pp. 500-502
Author(s):  
Pablo Yagupsky ◽  
Rafael Gorodischer
Keyword(s):  
Blood Pressure ◽  
Antihypertensive Drugs ◽  
Complete Recovery ◽  
Blocking Agent ◽  
Assisted Ventilation ◽  
Antagonistic Effect ◽  
Arterial Blood ◽  
Clonidine Poisoning ◽  
Adrenergic Blockers ◽  
Adrenergic Blocking

The antihypertensive drug clonidine has a double and antagonistic effect on arterial blood pressure. As a result of activation of peripheral α-adrenergic receptors, it causes a transient increase in blood pressure; by a central action it decreases sympathetic tone which results in sustained bradycardia and hypotension. Both central and peripheral effects are experimentally blocked by tolazoline, an α-adrenergic blocking agent. The toxic symptoms seen in clonidine poisoning are usually produced by the central effect. A case of severe clonidine poisoning in a 9-month-old infant is reported. The clinical picture included coma, miosis, apneic spells, bradycardia, and hypertension. Rapid and complete recovery was obtained with supportive treatment that included assisted ventilation. No adrenergic blockers or antihypertensive drugs were given. Use of tolazoline in cases of clonidine overdose in children remains controversial. Supportive measures alone may be adequate for even the most severe cases.

Once-Daily Treatment for Mixed Anxiety/Depressive States: A Comparison of Slow Release Amitriptyline and Fluphenazine with Nortriptyline

1977 ◽  
Vol 5 (2) ◽  
pp. 109-113 ◽  
Author(s):  
R V Magnus ◽  
A A Schiff
Keyword(s):  
Side Effects ◽  
Sustained Release ◽  
Slow Release ◽  
Anxiolytic Effect ◽  
Daily Treatment ◽  
Dry Mouth ◽  
Double Blind ◽  
Once Daily ◽  
Therapeutic Advantage ◽  
Depressive States

Patients suffering from mixed anxiety/depressive states referred to a psychiatric out-patient clinic completed a four week course of either a once-daily tablet of 30 mg nortriptyline with 1· 5 mg fluphenazine, or a sustained release capsule of 50 mg amitriptyline once daily, on a double-blind basis. Depression improved satisfactorily on either treatment, but there was a greater reduction of anxiety on fluphenazine/nortriptyline. Drowsiness, however, occurred more frequently among the patients on amitriptyline, suggesting the sedative properties of this drug did not substitute adequately for a specific anxiolytic effect. Dry mouth was also noticeably more frequent with amitriptyline. As might be expected on pharmacokinetic and physiological grounds, the results suggest that the sustained release characteristics of the amitriptyline preparation lead to a maximization of side-effects during the day without conferring any therapeutic advantage.

Antihypertensive Efficacy and Safe Use of Once-Daily Sustained-Release Diltiazem in the Elderly: A Comparison with Captopril

1995 ◽  
Vol 23 (4) ◽  
pp. 244-253 ◽  
Author(s):  
J Nicaise ◽  
E Neveux ◽  
P Blondin ◽  
Keyword(s):  
Blood Pressure ◽  
Sustained Release ◽  
Diastolic Blood Pressure ◽  
Blood Pressure Reduction ◽  
The Elderly ◽  
Double Blind ◽  
Once Daily ◽  
Supine Diastolic Blood Pressure ◽  
Normal Limits ◽  
Electrocardiographic Parameters

The efficacy and safety of sustained-release diltiazem, 200 – 300 mg once daily was compared with that of captopril, 12.5 – 25 mg twice-daily, in 100 elderly patients (65 – 85 years old) with mild to moderate essential hypertension (supine diastolic blood pressure 95 – 115 mmHg). All patients received placebo for 2 weeks, followed by an 8-week double-blind period, and were randomized to either diltiazem ( n = 50) or captopril ( n = 50). Their blood pressure was measured at trough level at week 4 immediately before dosing, i.e. 24 h post diltiazem dose or 12 h post captopril dose. Also at week 4, in non-responders, diltiazem was increased from 200 to 300 mg once daily and captopril from 12.5 to 25 mg twice daily to achieve a target supine diastolic blood pressure reduction of at least 10 mmHg or a diastolic blood pressure below 90 mmHg. Supine diastolic blood pressure, at week 8, was significantly ( P < 0.001) reduced from 102 ± 1 to 90 ± 1 mmHg with diltiazem and from 103 ± 1 to 89 ± 1 mmHg with captopril, bringing this parameter within normal limits for both groups. Supine systolic blood pressure was also significantly ( P < 0.001) reduced. Target blood pressure was achieved in 68% of patients taking diltiazem and in 70% taking captopril. Distribution of adverse events was comparable in both groups; no significant changes in laboratory or electrocardiographic parameters occurred. Two serious events were reported with captopril: one sudden death and one cerebrovascular stroke. Sustained-release diltiazem once a day is a convenient, well tolerated, first line treatment for hypertension in the elderly, for whom the possibility of using two dose levels allows a close regimen adjustment, 200 mg being recommended as a starting dose.

Clinical Evaluation of Atenolol in Hypertension

1976 ◽  
Vol 51 (s3) ◽  
pp. 513s-515s
Author(s):  
L. Hansson ◽  
B. E. Karlberg ◽  
H. Åberg ◽  
A. Westerlund ◽  
N. C. Henningsen ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Essential Hypertension ◽  
Blocking Agent ◽  
Long Term Results ◽  
Double Blind ◽  
Hypertensive Patients ◽  
Arterial Blood ◽  
Obstructive Airways Disease ◽  
Blind Comparison

1. Atenolol (ICI 66.082, Tenormin) is a new β-adrenoreceptor-blocking agent, devoid of intrinsic sympathomimetic and membrane-stabilizing properties. It does not cross the blood—brain barrier. 2. Atenolol given to hypertensive patients in initial open trials reduced arterial blood pressure significantly. 3. A double-blind comparison between atenolol and placebo in forty-five patients with essential hypertension demonstrated that atenolol gave a statistically significant reduction of blood pressure (Δ 28/15 mmHg, P < 0·005). 4. The optimum anti-hypertensive dose of atenolol in patients with mild to moderately severe essential hypertension was 200 mg daily. 5. Atenolol was compared with propranolol in thirty patients with essential hypertension. No statistically significant differences of anti-hypertensive effect were observed between the two drugs. 6. Long-term results (up to 2 years) in 117 hypertensive patients indicate that drug tolerance is good. No serious toxic effects were observed. 7. In four of twelve hypertensive patients with obstructive airways disease atenolol had to be withdrawn owing to deterioration of ventilatory function.

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