A comparison of timolol and propranolol in essential hypertension

Lohmöller, G; Fröhlich, Edward D.

doi:10.1016/0002-8703(75)90148-9

Cited by 38 publications

(10 citation statements)

References 6 publications

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“…Equipotent doses of timolol and PROPRANOLOL has been found to be effective as an antihypertensive agent as a single drug and especially in combination with other drugs such as diuretics or vasodilators. "'18 Timolol is a new beta-adrenergic blocking drug with no membrane stabilizing effect and with no intrinsic sympathomimetic activity which has also been found effective as an antihypertensive agent.8 10, 13,19 Franciosa and associates8 reported that equipotent doses of propranolol and timolol which caused a similar degree of inhibition of amyl nitrite induced tachycardia had similar effects on lowering blood pressure and heart rate. However, after five weeks of treatment, the mean cardiac output rose slightly in six patients receiving timolol, whereas the mean cardiac output decreased significantly in 11 patients receiving propranolol.…”

mentioning

confidence: 99%

Effect of timolol versus propranolol on hypertension and hemodynamics.

Aronow¹,

Ferlinz²,

Vicario³

et al. 1976

Circulation

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SUMMARY The effect of timolol versus propranolol on hypertension, hemodynamics, and plasma renin activity was evaluated in 20 men. After two weeks of placebo, 11 men received timolol 30 to 60 mg daily, and nine men received propranolol, 240 to 480 mg daily, for five weeks in a double-blind randomized study. The 20 men then received placebo again for two weeks. Right heart catheterization was performed in all 20 patients after two weeks of the first placebo and after five weeks of timolol or propranolol. Equipotent doses of timolol and PROPRANOLOL has been found to be effective as an antihypertensive agent as a single drug and especially in combination with other drugs such as diuretics or vasodilators."'18 Timolol is a new beta-adrenergic blocking drug with no membrane stabilizing effect and with no intrinsic sympathomimetic activity which has also been found effective as an antihypertensive agent.8 10, 13,19 Franciosa and associates8 reported that equipotent doses of propranolol and timolol which caused a similar degree of inhibition of amyl nitrite induced tachycardia had similar effects on lowering blood pressure and heart rate. However, after five weeks of treatment, the mean cardiac output rose slightly in six patients receiving timolol, whereas the mean cardiac output decreased significantly in 11 patients receiving propranolol. Franciosa and Freis'7 also reported in another study that timolol administered for five weeks to 11 patients caused a significant decrease in mean supine systolic and diastolic blood pressure, a significant decrease in mean heart rate, and no significant change in cardiac output.Therefore, we performed a double-blind randomized study to evaluate the effect of timolol versus propranolol on blood pressure, heart rate, stroke index, cardiac index, systemic vascular resistance, and other hemodynamic variables. This paper presents the data in the 20 patients who completed this study. Materials and MethodsTwenty patients with diastolic hypertension were to complete this study. Twenty-three men received either timolol or propranolol. The mean age of the 20 men who completed this study was 52.7 ± 10.8 years. None of the patients had coronary heart disease, valvular heart disease, a history of cerebrovascular disease, a history of congestive heart failure, poor myocardial contractility, sinus bradycardia, bundle branch block, atrioventricular block, chronic obstructive lung disease, a history of bronchial asthma, allergic rhinitis, or peripheral vascular disease. Informed consent was obtained from all participants.propranolol were equally effective in significantly lowering supine and upright systolic and diastolic blood pressure and heart rate recorded on an outpatient basis. Equipotent doses of timolol and propranolol caused similar hemodynamic effects including similar significant depression of cardiac index. Equipotent doses of timolol and propranolol caused similar marked depression of plasma renin activity. The hypotensive action of timolol and of propranolol was unrelated to their ef...

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confidence: 99%

Effect of timolol versus propranolol on hypertension and hemodynamics.

Aronow¹,

Ferlinz²,

Vicario³

et al. 1976

Circulation

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“…Timolol treatment has been safely used in clinical pediatrics and has been employed as a first-line treatment for glaucoma in the field of pediatric ophthalmology for 30 years (16). According to previous studies, the pharmacological effects of timolol are 4-10 times more marked than those of propranolol (17)(18)(19). Ni et al (19) applied 0.5% timolol eye drops, twice per day, to the faces and necks of 4 patients with IH (age range, 3-10 months).…”

Section: Discussionmentioning

confidence: 99%

Efficacy of low-dose 90Sr-90Y therapy combined with topical application of 0.5% timolol maleate solution for the treatment of superficial infantile hemangiomas

Zhu

Liu

Duan

et al. 2015

Experimental and Therapeutic Medicine

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The aim of the present study was to investigate the clinical efficacy and safety of low-dose Sr-Y therapy combined with the topical application of 0.5% timolol maleate solution for the treatment of superficial infantile hemangiomas (IHs). A total of 72 infants with hemangiomas were allocated at random into the observation group (17 cases aged ≤3 months, 20 cases aged >3 months) or the control group (15 cases aged ≤3 months, 20 cases aged >3 months). The observation group was treated with low-dose Sr-Y combined with timolol, while the control group received an identical dose of Sr-Y with physiological saline. Data were collected for statistical analysis, and treatment efficacy was compared between the two groups. In the observation group, 100% (37/37) of subjects exhibited an 'excellent' response to the treatment, while 94.1% (16/17) of patients aged ≤3 months and 85.0% (17/20) aged >3 months were classed as being cured. In the control group, the treatment was classed as 'effective' in 100% (35/35) of the subjects, while the excellent response rate was 86.7% (13/15) among the infants aged ≤3 months and 75.0% (15/20) among the infants aged >3 months. The 'cure' rates in the control group were 66.7% (10/15) and 60.0% (12/20) for the ≤3-month- and >3-month-old subjects, respectively. The excellent response and cure rates were notably higher in the observation group than those in the control group. Comparison between the two groups revealed a χ value of 13.90 (P<0.01) for excellent responses in subjects aged ≤3 months, while for patients aged >3 months the χ value was 28.57 (P<0.01). Analysis of the cure responses gave similar results [≤3 months, χ=23.22 (P<0.01); >3 months, χ=15.67 (P<0.01)]. At 3-4 months after the first course of treatment, the cure rate was 33.3% (11/33) in the observation group, which was significantly higher than the rate of 18.32% (4/22) in the control group (χ=5.92, P<0.05). No serious adverse reactions were observed in either group. In summary, low-dose Sr-Y therapy combined with the topical application of 0.5% timolol maleate induces a rapid response in superficial IH, with excellent efficacy and no obvious adverse reactions, and may represent a clinically applicable intervention.

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“…However, in the first hemodyanamic study of propranolol in patients with hypertension, we reported the pathophysiological paradox demonstrating that the earlier agent propranolol reduced cardiac output whereas TPR increased even further Ulrych et al 1968]. Recognizing that the TPR is simply a calculated hemodynamic datum, we conducted a subsequent series of experimental laboratory and clinical studies involving several other beta blockers designed to determine changes in the actual vascular resistances of each of the vasculatures within the total circulation [Dunn et al 1987;1983;1978;Frohlich et al 1984;Dreslinski et al 1982;Dunn and Frohlich, 1981;Nishiyama et al 1976a;1976b;Lohmö ller and Frohlich, 1975]. These studies demonstrated that vascular resistance became reduced in the renal and certain other circulations whereas it increased in skeletal muscle and elsewhere [Nishiyama et al 1976a;1976b].…”

Section: Hemodynamic Issuesmentioning

confidence: 99%

Role of beta-adrenergic receptor blocking agents in hypertensive diseases: personal thoughts as the controversy persists

Fröhlich

2009

Therapeutic Advances in Cardiovascular Disease

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The long history of the beta-adrenergic receptor blockers for the treatment of hypertension is fraught with many controversies. The first compound had severe untoward effects preventing their use until propranolol was introduced. It was found effective for treatment of angina pectoris since not all patients with hypertension responded to monotherapy with a meaningful reduction of pressure. Nevertheless, the beta-blockers were most effective in: younger patients, especially with hyperkinetic circulation; with co-morbid diseases (e.g. coronary arterial disease with or without prior myocardial infarction); or when used with a diuretic. Subsequently with the advent of meta-analysis to evaluate more generalized experience, controversy resumed with statements made to exclude beta-blockers for initial hypertensive therapy. Support for this argument was gained with reports of patients developing 'dysglycemia' with treatment. However, exclusion of any one therapeutic class for a multifactorial disease such as hypertension seems unrealistic. Meta-analysis confounded this conclusion since inadequate numbers of patients having specific clinical and biological characteristics were included (especially young patients). This is particularly important at this time when third-party reimbursement procedures are particularly relevant and when the primary care physician must deal with the individual patient. The NICE report has introduced specific thinking along these lines. In-and-of itself, its recommendations are reasonable, but current articles continue to suggest that the 'older' beta-blockers should be excluded from national guidelines for initial antihypertensive therapy. Personally, I disagree; and, no doubt, controversy will continue.

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A comparison of timolol and propranolol in essential hypertension

Cited by 38 publications

References 6 publications

Effect of timolol versus propranolol on hypertension and hemodynamics.

Effect of timolol versus propranolol on hypertension and hemodynamics.

Efficacy of low-dose 90Sr-90Y therapy combined with topical application of 0.5% timolol maleate solution for the treatment of superficial infantile hemangiomas

Role of beta-adrenergic receptor blocking agents in hypertensive diseases: personal thoughts as the controversy persists

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