title: Safety and antihypertensive efficacy of carvedilol and atenolol alone and in combination with hydrochlorothiazide.
abstract: Carvedilol has been shown to be effective and safe in patients with essential hypertension when given as monotherapy. In this double-blind, randomized, group-comparative study, 2 groups of 59 patients with mild to moderate essential hypertension [median supine systolic/diastolic blood pressure at baseline (SBP/DBP), 168/105 mmHg] were treated with either 25 mg carvedilol once daily (o.d.) or 50 mg atenolol o.d. for 4 weeks. Responders at 4 weeks (DBP, less than 90 mmHg) terminated the study. Nonresponders continued the study. Hydrochlorothiazide (HCTZ) was added at 25 mg o.d. for a further 6 weeks. The median blood pressure decreased under monotherapy with carvedilol (n = 59) from 167/105 at baseline to 155/94 mmHg after 4 weeks, and in the atenolol group (n = 59) it decreased from 168/105 to 162/97 mmHg. The patients who received carvedilol in combination with HCTZ and were evaluated for efficacy (n = 38) showed a decrease in SBP/DBP from 156/97 at the end of monotherapy to 145/88 mmHg after 10 weeks; the combination of atenolol with HCTZ (n = 44) reduced BP from 162/97 to 147/88. Both carvedilol and atenolol were safe when given either alone or in combination with HCTZ. In conclusion, after long-term administration, 25 mg carvedilol o.d. and 50 mg atenolol o.d. significantly reduced both SBP and DBP over 24 h. The addition of HCTZ led to a further increase in antihypertensive efficacy. Combined treatment with carvedilol or atenolol and HCTZ was very well tolerated, without hypotensive events or relevant changes in objective safety parameters.
authors.affiliation: Boehringer Mannheim GmbH, FRG.
authors.forename: L
authors.initials: L
authors.lastname: Widmann
authors.forename: R
authors.initials: R
authors.lastname: van der Does
authors.forename: M
authors.initials: M
authors.lastname: Hörrmann
authors.forename: M
authors.initials: M
authors.lastname: Machwirth
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000009:adverse effects / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D001262:Atenolol / Q000009:adverse effects / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects; D002227:Carbazoles / Q000009:adverse effects / Q000627:therapeutic use*; D000077261:Carvedilol; D002784:Cholesterol / Q000097:blood; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D006852:Hydrochlorothiazide / Q000009:adverse effects / Q000627:therapeutic use*; D006973:Hypertension / Q000188:drug therapy* / Q000503:physiopathology; D008074:Lipoproteins / Q000097:blood; D008297:Male; D008875:Middle Aged; D011412:Propanolamines / Q000009:adverse effects / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic; D014280:Triglycerides / Q000097:blood
chemical_list: D000319:Adrenergic beta-Antagonists; D002227:Carbazoles; D008074:Lipoproteins; D011412:Propanolamines; D014280:Triglycerides; D006852:Hydrochlorothiazide; D000077261:Carvedilol; D001262:Atenolol; D002784:Cholesterol