Adverse Effects of Antihypertensive Drugs

Husserl, Fred E.; Messerli, Franz H.

doi:10.2165/00003495-198122030-00002

Cited by 52 publications

(14 citation statements)

References 151 publications

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“…Side-effects from the central nervous system (CNS), such as nightmares, hallucinations and sleep disturbances have been reported in many patients treated with p-adrenergic-blocking drugs (1,2). These symptoms often occur early during treatment and may be of such a severity that the drug must be withdrawn.…”

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confidence: 99%

Melatonin Secretion Related to Side‐effects of β‐Blockers from the Central Nervous System

Brismar

Hylander

Eliasson

et al. 1988

Journal of Internal Medicine

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In two studies of hypertensive patients the relationship between β‐blocker‐induced CNS side‐effects and the nightly urinary secretion of melatonin was analysed. In one group (n=10) placebo, atenolol (mean dose 86 mg/day) or propranolol (mean dose 305 mg/day) were given in a double‐blind, randomised design. In the other (n = 13) 100–400 mg metoprolol was given daily (mean dose 197 mg). After 4 weeks of treatment all β‐blockers reduced melatonin excretion, but the effect was significant only for metoprolol. Sleep disturbance records revealed more disturbed nights in the metoprolol group compared with the propranolol and the atenolol groups, even when the difference in age between the groups was controlled for. In the metoprolol group a significant relationship (p<0.05) was found between the fall in melatonin and the percentage of disturbed nights. Severe CNS side‐effects, such as nightmares, occurred only in patients treated with metoprolol (21%), which in all cases were accompanied by low levels of melatonin. Our data suggest that the CNS side‐effects during β‐blockade are related to a reduction of melatonin levels.

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mentioning

confidence: 99%

Melatonin Secretion Related to Side‐effects of β‐Blockers from the Central Nervous System

Brismar

Hylander

Eliasson

et al. 1988

Journal of Internal Medicine

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“…For instance, Perry 7 found the most common cause of falls in the elderly population was dizziness or syncope. Most antihypertensive agents, including diuretics, ganglionic sympathetic blockers, and drugs that act on the central nervous system can alter hemodynamics and result in orthostatic hypotension 8 . It is possible that the use of these drugs by the elderly can result in the frequent occurrence of central nervous system symptoms.…”

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confidence: 99%

“…Most antihypertensive agents, including diuretics, ganglionic sympathetic blockers, and drugs that act on the central nervous system can alter hemodynamics and result in orthostatic hypotension. 8 It is possible that the use of these drugs by the elderly can result in the frequent occurrence of central nervous system symptoms. In this study, we used data collected by the Dunedin Program to evaluate the relationship between use of antihypertensive drugs and reported symptoms of dizziness, fainting, and "blacking-out spells.…”

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confidence: 99%

Central Nervous System Symptoms of Elderly Subjects Using Antihypertensive Drugs

Hale¹,

Stewart²,

Marks³

1984

J American Geriatrics Society

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The effects of antihypertensive agents on the frequencies of reported fainting, dizziness, losses of consciousness, and bone fractures were studied in a large, ambulatory elderly population. The frequencies of these symptoms were compared for subjects who used one or more of nine different antihypertensive agents and for subjects who were not using these medications and who served as a control group. Over 40 per cent of the total population were using at least one of the nine drug groups. Women who used antihypertensive medications reported significantly more fainting (P less than 0.001), dizziness (P less than 0.005) and "blacking-out spells" (P less than 0.002) but significantly fewer bone fractures (P less than 0.02) compared with women who were not using such medication in the control group. For men, the use of only one drug group, propranolol, was associated with a significant increase in fainting and dizziness but not blacking-out spells compared with men in the control. These results suggest that elderly persons may be subject to a variety of central nervous system side effects induced by antihypertensive drugs.

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“…The nature and incidence of other symptoms reported with perindopril were similar to those observed with atenolol and corresponded to those usually described with other antihypertensive drugs (Helgeland et a1. 1986;Husserl & Messerli 1981). Taste disturbances or orthostatic hypotension were not reported in the perindopril group.…”

Section: Discussionmentioning

confidence: 90%

Antihypertensive Effect and Acceptability of Perindopril

et al. 1991

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The aim of this 3-month double-blind study was to assess the antihypertensive effect and acceptability of perindopril in comparison with atenolol in patients with mild to moderate essential hypertension. After a 4-week run-in placebo period, 40 patients with supine diastolic blood pressure (DBP) between 95 and 120mm Hg were randomised to receive perindopril 4mg or atenolol 50mg once daily. If supine DBP was> 90mm Hg, treatment was adjusted monthly: first by doubling the dose and then by the addition of chlorthalidone 50mg. Except for standing DBP, which was higher in the perindopril group than in the atenolol group, the 2 groups were homogeneous prior to treatment. After 3 months of active treatment, the decrease in supine blood pressure and standing DBP was not significantly different between the 2 groups. In contrast, the fall in standing systolic blood pressure was greater with perindopril than with atenolol. The percentage of patients (85%) who achieved supine DBP of ~ 90mm Hg in the perindopril group was not significantly different from the atenolol group (80%). Monotherapy resulted in control of supine DBP in 55% of the perindopril group and 65% of the atenolol group; the addition of chlorthalidone resulted in control of supine DBP in 30 and 15%, respectively. No patient was withdrawn from the study. The nature and incidence of side effects were similar between the 2 groups. Changes in laboratory parameters were minor and not significantly different between the 2 groups.Perindopril was as effective as atenolol in lowering blood pressure. Clinical and biological acceptability was satisfactory and similar with both drugs. Perindopril may therefore be recommended as first-line treatment for mild to moderate essential hypertension.

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Adverse Effects of Antihypertensive Drugs

Cited by 52 publications

References 151 publications

Melatonin Secretion Related to Side‐effects of β‐Blockers from the Central Nervous System

Melatonin Secretion Related to Side‐effects of β‐Blockers from the Central Nervous System

Central Nervous System Symptoms of Elderly Subjects Using Antihypertensive Drugs

Antihypertensive Effect and Acceptability of Perindopril

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