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Long-term experience with tertatolol in hypertension
Insights
This study shows that tertatolol effectively controls hypertension over 12 months, with most patients achieving normal blood pressure (BP) and many remaining on monotherapy. The beta-blocker demonstrated sustained antihypertensive activity in diverse patient groups.
Area of Science:
- Cardiology
- Pharmacology
- Hypertension Management
Background:
- Placebo-resistant hypertension (HT) poses a significant challenge in long-term patient management.
- Beta-blocking agents are a cornerstone of antihypertensive therapy, but novel agents require thorough evaluation.
- Assessing the efficacy and tolerability of new antihypertensive drugs is crucial for clinical practice.
Purpose of the Study:
- To evaluate the long-term (12-month) antihypertensive activity of tertatolol (5 mg once daily).
- To assess the acceptability and treatment adaptation of tertatolol in patients with stable, placebo-resistant hypertension.
- To determine the percentage of patients achieving blood pressure (BP) normalization under different therapeutic regimens.
Main Methods:
- An open-label, 12-month study involving 110 outpatients with stable hypertension.
- Patients received tertatolol (T) 5 mg once daily, with treatment adjusted by adding a diuretic (D) and/or vasodilator (V) as needed.
- Blood pressure (BP) was monitored throughout the study to assess treatment efficacy.
Main Results:
- At 12 months, 93.6% of patients achieved controlled blood pressure (diastolic BP < 95 mm Hg).
- Monotherapy with tertatolol controlled BP in 72.7% of patients; 16.4% required dual therapy (T+D), and 4.5% needed triple therapy (T+D+V).
- Significant reductions in systolic BP (26.4 mm Hg) and diastolic BP (19.9 mm Hg) were observed (p<0.01).
Conclusions:
- Long-term administration of tertatolol (5 mg once daily) is effective and well-tolerated for managing hypertension.
- Treatment adaptation with diuretics and vasodilators allows for sustained BP control in a high percentage of patients.
- Tertatolol demonstrates early and sustained antihypertensive effects, with comparable efficacy across different age groups and baseline BP levels.
Abstract:
The long-term antihypertensive activity and acceptability of a new beta-blocking agent tertatolol (T) (5 mg once daily) was assessed in a 12-month (M0-M12) open study, in 110 out-patients (64 men, 46 women, mean age 53.5 +/- 1.0 years), presenting with stable placebo-resistant hypertension (HT) (95 less than or equal to diastolic blood pressure less than 130 mm Hg on 3 occasions during a 1-month placebo run-in period). To obtain normalization of blood pressure (BP), treatment was adapted as from M3, adding a combined thiazide- and potassium sparing-diuretic (D) and, if necessary, the vasodilator dihydralazine (V). At M12, 93.6% of patients were controlled (supine diastolic BP less than 95 mm Hg) among whom 72.7% under T monotherapy, 16.4% under double therapy (T + D) and 4.5% under triple therapy (T + D + V). Overall variations of BP were 26.4 mm Hg for SBP (from 171.7 +/- 1.6 to 145.3 +/- 1.3 mm Hg; p less than 0.01) and 19.9 mm Hg for DBP (from 105.6 +/- 0.7 to 85.7 +/- 0.6 mm Hg; p less than 0.01). Under T monotherapy, reduction in diastolic BP occurred early (15.0 mm Hg at M1) and was sustained thereafter (19.5 mm Hg at M12); HT control was comparable in the 40- to 60- and greater than 60-year-old age groups (respectively 67.6% and 74.1%) and higher in the less than 40-year-old group (100%). It also rose from 61.2% when initial diastolic BP was greater than 105 mm Hg to 82.0% when it was less than or equal to 105 mm Hg.(ABSTRACT TRUNCATED AT 250 WORDS)