Comparison of bevantolol and atenolol for systemic hypertension

In an international, randomized, double-blind trial involving 229 patients, 400 mg of bevantolol was compared with 100 mg of atenolol (both in single daily doses) in the management of mild to moderate hypertension (diastolic blood pressure [BP] 95 to 115 mm Hg after a 4-week placebo washout period). Patients were then randomized to 12 weeks of treatment with either drug. Patients were evaluated at 2, 4, 8 and 12 weeks during the drug treatment period. Efficacy measurements were based on sitting and standing BP and heart rate. Adverse experiences were recorded on patient checklists, by spontaneous complaints and by 12-lead electrocardiography and funduscopy. A subgroup of 104 patients had heart rate and BP determinations every 24 to 26 hours after drug ingestion. Overall results showed both drugs to be comparably effective; no real difference was shown after 12 weeks of treatment. Bevantolol caused a more gradual BP decrease than atenolol. Both regimens were associated with decreased heart rate (less marked with bevantolol, p less than 0.001). Data from the 24-hour assessment subgroup showed similar results for both drugs, with a somewhat lower decrease in BP for bevantolol, which persisted throughout the study. Both drugs lowered sitting BP; the decrease was significantly less with bevantolol after the second week of therapy. The mean number of adverse experiences was similar for both drugs; cardiovascular side effects were less frequent with bevantolol. Patients taking bevantolol showed a higher incidence of digestive system side effects. Bevantolol maintained a 24-hour antihypertensive effect.(ABSTRACT TRUNCATED AT 250 WORDS)