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Tertatolol in hypertension. Long-term therapy in 2,338 patients
O Guery1, D Herpin, M Lecasble
1Institut de Recherches Internationales Servier, Neuilly-sur-Seine, France.
Insights
Tertatolol effectively lowers blood pressure in mild to moderate hypertension. This study in 2,338 patients showed significant BP reduction with tertatolol (T) alone or with diuretics, with rare side effects.
Area of Science:
- Cardiology
- Pharmacology
- Nephrology
Background:
- Mild to moderate hypertension affects a significant patient population.
- Effective and well-tolerated antihypertensive medications are crucial for cardiovascular health.
- Understanding drug effects on renal function is important for comprehensive patient care.
Purpose of the Study:
- To evaluate the efficacy and tolerability of tertatolol in managing mild to moderate hypertension.
- To assess the impact of tertatolol monotherapy versus combination therapy with a diuretic.
- To investigate the effects of tertatolol on plasma creatinine levels and renal function.
Main Methods:
- A one-year study involving 2,338 patients with mild to moderate hypertension.
- Initiation of tertatolol (T) at 5 mg once daily, with dosage adjustment or diuretic addition based on blood pressure (BP) and heart rate.
- Monitoring of BP, heart rate, and plasma creatinine levels throughout the study period.
Main Results:
- Blood pressure normalization was achieved in 88.8% of patients (66.1% on T alone, 22.7% on T + diuretic).
- Significant decrease in diastolic BP by 18.4 mm Hg (P < .001) and continuous reduction in supine systolic and diastolic BP.
- Overall side effects were rare (6.5% discontinuation); plasma creatinine significantly decreased, particularly in patients with initial levels ≥ 100 mumol/L.
Conclusions:
- Tertatolol is an efficient and well-tolerated antihypertensive drug for mild to moderate hypertension.
- Combination therapy with a diuretic can further enhance BP control when needed.
- Tertatolol demonstrates a beneficial effect on renal function, especially in patients with initially reduced renal function.
Abstract:
Tertatolol has been studied in 2,338 patients with mild to moderate hypertension over a one year period. Tertatolol (T) was initiated alone (5 mg once daily) and if satisfactory control of blood pressure (BP) (diastolic BP less than 95 mm Hg) was not achieved, treatment was adapted at the third or sixth month either by increasing the dosage (heart rate greater than 70 beats/min), or by adding a potassium-sparing diuretic (heart rate less than or equal to 70 beats/min). Blood pressure normalization was achieved in 88.8% of the study population: 66.1% on single and 22.7% on dual therapy. The decrease of diastolic BP was 18.4 mm Hg (from 102.8 +/- 0.2 to 84.4 +/- 0.2 mm Hg, P less than .001). Tertatolol alone or associated with diuretic (T + D) induced a significant and continuous decrease in supine systolic and diastolic BP. Overall side effects were rare, leading in only 6.5% of the cases to the discontinuation of the drug. Plasma creatinine significantly decreased in the single therapy group only (from 92.2 +/- 0.5 to 90.1 +/- 0.5 mumol/L, P less than .01). In patients with initial plasma creatinine greater than or equal to 100 mumol/L (n = 661), plasma creatinine markedly decreased (-10%, from 114.6 +/- 0.7 to 103.4 +/- 0.8 mumol/L, P less than .01), and to the same extent with T or T + D. Thus, this large-scale study confirms that tertatolol is an efficient and well-tolerated antihypertensive drug, which improves renal function, especially when initially reduced.