Comparison of bisoprolol with atenolol for systemic hypertension in four population groups (young, old, black and nonblack) using ambulatory blood pressure monitoring

Neutel, Joel M.; Smith, David H.G.; Ram, C. Venkata S.; Lefkowitz, Martin; Kazempour, Muhanna; Weber, Michael A.

doi:10.1016/0002-9149(93)90216-y

Cited by 18 publications

(11 citation statements)

References 25 publications

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“…Most previous studies that reported race-specific baseline blood pressures (Table 1) had a 2-to 4-mm Hg higher baseline diastolic blood pressure among blacks compared with whites. [11][12][13][14][15][16] Thus, these studies may overestimate the difference in the proportion of whites and blacks achieving a target blood pressure after administration of a specific antihypertensive drug. Many other studies did not report baseline blood pressure separately for whites and blacks (Table 1), thereby making if difficult to interpret their results regarding racial differences in achieving a treatment goal.…”

Section: Discussionmentioning

confidence: 99%

Overlap Between Whites and Blacks in Response to Antihypertensive Drugs

Sehgal

2004

Hypertension

111

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Abstract-On average, whites and blacks differ in their response to specific antihypertensive drugs. These differences are often highlighted in reviews and practice guidelines. However, there is wide variation in drug-associated changes in blood pressure within each race. The goal of this meta-analysis is to quantitate how often whites and blacks have similar responses to specific antihypertensive drugs. Computerized searches of MEDLINE (1983 to March 2003 and manual searches of references listed in identified articles were performed. Studies were included if they provided race-specific changes in blood pressure. Fifteen studies with a total of 9307 white subjects and 2902 black subjects were analyzed. For drug-associated changes in diastolic blood pressure, the mean difference between whites and blacks ranged from 0.6 to 3.0 mm Hg while the standard deviation within each race ranged from 5.0 to 10.1 mm Hg. The percentage of whites and blacks with similar drug-associated changes in diastolic blood pressure was 90% (95% confidence interval: 81 to 99) for diuretics, 90% (95% CI: 83 to 97) for ␤-blockers, 95% (95% CI: 92 to 98) for calcium channel blockers, and 81% (95% CI: 76 to 86) for angiotensin converting enzyme inhibitors. The percentage of whites and blacks with similar drug-associated changes in systolic blood pressure ranged from 83% to 93%.

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Section: Discussionmentioning

confidence: 99%

Overlap Between Whites and Blacks in Response to Antihypertensive Drugs

Sehgal

2004

Hypertension

111

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“…It has been claimed that beta-blockers are less effective than diuretics. 2 However, Neutel et al 3 found in their study that two beta-blockers (atenolol, bisoprolol) have clearly different anti-hypertensive effects in patients over 65 years of age. Bisoprolol produced a greater reduction in BP than atenolol.…”

Section: Discussionmentioning

confidence: 97%

“…Owing to the long time duration bisoprolol in a single dose per day is sufficient to control BP during 24 h and prevents the rise of BP in the early morning. 3 Hypertension in the elderly patients is characterised by a blunted baroreflex and ␤ 1 -adrenoceptormediated reponses, decreased vascular compliance and increased peripheral vascular resistance. 1 One possible explanation for the enhanced efficacy of bisoprolol in the elderly may be that it is more lipid soluble than atenolol.…”

Section: Discussionmentioning

confidence: 99%

Bisoprolol in the treatment of hypertension in the elderly

Broncel¹,

Chojnowska-Jezierska²,

Adamska-Dyniewska³

1998

J Hum Hypertens

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The aim of the study was to examine the hypotensive efficacy and tolerance of bisoprolol in elderly patients. Sixty patients (40 Ͻ65 years and 20 Ͼ65 years) with mild-to-moderate essential hypertension (diastolic blood pressure (DBP) between 95 and 109 mm Hg) were included in the study. After a 2-week run-in period on placebo, patients began bisoprolol therapy (5 mg/d) for 12 weeks. After 4 weeks the dose was increased to 10 mg/d in those with a DBP у95 mm Hg. Additionally, in 10 patients over 65 years old, 24-h ambulatory BP monitoring (ABPM) was performed, after placebo and

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“…It is important for physicians to select agents that provide adequate blood pressure control over the entire 24‐hour dosing interval. Several medications marketed as once‐a‐day agents tend to loose efficacy during the last few hours of the dosing interval 25 . Loss of blood pressure control tends to coincide with the rapid increase in blood pressure during arousal from sleep, 25 and the time during which the peak incidence of non‐embolic stroke and myocardial infarction occurs 26 .…”

Section: Convenience Of Dosingmentioning

confidence: 99%

Improving Patient Compliance: A Major Goal in the Management of Hypertension

Neutel

Smith

2003

J of Clinical Hypertension

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The primary goal in the treatment of hypertension is to reduce the incidence of cardiovascular events in hypertensive patients. Studies performed to assess the impact of treating hypertension have revealed very disappointing reductions in the incidence of coronary heart disease. There are several reasons for these poor reductions in the incidence of cardiovascular disease; however, the most important is related to the fact that worldwide less than one quarter of hypertensive patients are adequately controlled for hypertension. Again, there are multiple reasons for these poor blood pressure (BP) control rates; however, most physicians would agree that patient compliance with their antihypertensive treatment is a major contributing factor. This is an area that we need to refocus on in our management of hypertensive patients. Issues such as safety, convenience, polypharmacy, cost, and education in the selection of antihypertensive agents are all critically important issues in the treatment of hypertensive patients. In addition, the level of patient involvement in their treatment seems to be essential in obtaining goal BP. Newer approaches to the management of hypertension such as earlier control of BP and the more aggressive use of low-dose combination therapy as first-line treatment of hypertension also need to be considered in our effort to improve BP control rates. Achieving goal BP in hypertensive patients is one of the most important clinical dilemmas facing physicians. There is little doubt that an improvement in control rates will result in substantial reductions in cardiovascular disease.

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Comparison of bisoprolol with atenolol for systemic hypertension in four population groups (young, old, black and nonblack) using ambulatory blood pressure monitoring

Cited by 18 publications

References 25 publications

Overlap Between Whites and Blacks in Response to Antihypertensive Drugs

Overlap Between Whites and Blacks in Response to Antihypertensive Drugs

Bisoprolol in the treatment of hypertension in the elderly

Improving Patient Compliance: A Major Goal in the Management of Hypertension

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