Comparison of urapidil and atenolol in hypertension

The antihypertensive efficacy of urapidil was compared with that of atenolol in a double-blind randomised parallel-group 10-week study. 44 patients with essential hypertension entered the study, and 43 with a supine DBP of 100 to 125 mm Hg after a 2-week placebo period were randomised either to urapidil (n = 22; 60 to 120 mg/day) or atenolol (n = 21; 50 to 100 mg/day) for 8 weeks. Blood pressure, heart rate, electrocardiogram (supine and standing) and side effects were recorded every week, and medical examinations and laboratory tests were done at the end of the placebo and active treatments. 36 patients completed the trial (17 on urapidil and 19 on atenolol). Patients' characteristics were similar in the two groups, and there were no differences between them in blood pressure and heart rate at the end of placebo period. Both drugs produced a significant fall in supine and standing blood pressure; urapidil decreased supine blood pressure from 164/109 to 150/96 (p less than 0.001), and atenolol decreased it from 167/111 to 146/94 mm Hg by week 8 (p less than 0.001). There were no differences in the blood pressure-reducing effects of the two drugs. There was no change in heart rate in the urapidil group, but a marked reduction occurred in the atenolol group, with significant differences from placebo and urapidil (p less than 0.001). Side effects were reported in 32% of the urapidil group and in 29% of the atenolol group; however, these were mild and transient in all but two patients (urapidil = 1, atenolol = 1) who were withdrawn.(ABSTRACT TRUNCATED AT 250 WORDS)