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Comparison of hydrochlorothiazide and hydrochlorothiazide plus bevantolol in hypertension
Insights
Bevantolol, a cardioselective beta-blocker, significantly enhanced blood pressure reduction in patients with hypertension when added to hydrochlorothiazide. This dual therapy proved safe and more effective than monotherapy alone.
Area of Science:
- Cardiology
- Pharmacology
Background:
- Essential hypertension is a prevalent cardiovascular condition.
- Management often involves diuretics and beta-blockers.
- Cardioselective beta-blockers offer targeted therapeutic effects.
Purpose of the Study:
- To evaluate the additional hypotensive effect of bevantolol.
- To assess bevantolol's efficacy in patients with mild to moderate essential hypertension.
- To compare dual therapy (bevantolol + hydrochlorothiazide) with monotherapy.
Main Methods:
- A study involving 244 patients with mild to moderate essential hypertension.
- Four weeks of monotherapy with hydrochlorothiazide (50 or 100 mg/day) or placebo.
- Subsequent four weeks of dual therapy with bevantolol (400 mg/day) added to the existing regimen.
- Measurement of mean diastolic blood pressure changes from baseline.
Main Results:
- Monotherapy with hydrochlorothiazide or placebo resulted in mean diastolic blood pressure decreases of 8.6, 8.8, and 4.3 mmHg, respectively.
- Addition of bevantolol led to further mean decreases of 7.5, 7.3, and 7.5 mmHg.
- Total mean diastolic pressure decreases from baseline were 16.1, 16.1, and 11.8 mmHg.
- Dual therapy showed significantly lower diastolic pressures than monotherapy (P < 0.001).
- Fewer adverse reactions were observed during dual therapy.
Conclusions:
- Bevantolol addition to thiazide diuretics provides safe and significantly improved control of mild to moderate hypertension.
- Dual therapy with bevantolol and hydrochlorothiazide is more effective than diuretic monotherapy.
- Bevantolol is a valuable option for enhancing antihypertensive treatment regimens.
Abstract:
The added hypotensive effect of bevantolol, a new cardioselective beta-blocker, was studied in 244 patients with mild to moderate essential hypertension following prior treatment with hydrochlorothiazide or placebo. After four weeks of monotherapy with 50 mg/day or 100 mg/day of hydrochlorothiazide or placebo, the mean diastolic blood pressure of the patients in these groups decreased from baseline by 8.6, 8.8, and 4.3 mmHg, respectively. During the subsequent four weeks of dual therapy with 400 mg/day of bevantolol added to the regimen, additional and uniform mean decreases of 7.5, 7.3, and 7.5 mmHg occurred, providing total mean diastolic pressure decreases from baseline of 16.1, 16.1, and 11.8 mmHg in the three groups, respectively. These diastolic pressures were significantly lower during dual therapy than during monotherapy and lower in both diuretic groups than in the placebo group during monotherapy and dual therapy (P less than 0.001). Fewer adverse reactions occurred during dual therapy than during monotherapy. The addition of bevantolol to a thiazide diuretic regimen provided safe and significantly better control of mild to moderate hypertension than did the diuretic alone.