Comparison of quinapril and atenolol as single drugs or in combination with hydrochlorothiazide in moderate to severe hypertensives, using automated ambulatory monitoring.

Lacourcière, Yves; Lefèbvre, J; Provencher, Pierre; Poirier, Luc

doi:10.1111/j.1365-2125.1993.tb05677.x

Cited by 6 publications

(2 citation statements)

References 27 publications

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“…All drugs significantly lowered 24‐hour SBP, but the decrease with atenolol was less than with the other drugs. In other studies, however, once‐daily atenolol in larger doses up to 100 mg has been shown to achieve greater decreases in DBP throughout the 24‐hour period than quinapril 20 mg/d 18 and during the daytime when compared with nebivolol in doses up to 5 mg 19 …”

Section: Discussionmentioning

confidence: 87%

Comparative Efficacy of Two Different β‐Blockers on 24‐Hour Blood Pressure Control

Sarafidis

Bogojevic

Basta

et al. 2008

J of Clinical Hypertension

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Section: Discussionmentioning

confidence: 87%

Comparative Efficacy of Two Different β‐Blockers on 24‐Hour Blood Pressure Control

Sarafidis

Bogojevic

Basta

et al. 2008

J of Clinical Hypertension

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“…This led to the contra‐indication of non‐selective β‐adrenoceptor blockers in patients with RP. However, this hypothesis is challenged by clinical observations of RP occurring in patients taking β‐adrenoceptor blockers with higher affinity for β 1 ‐adrenoceptors . In addition, in patients with primary RP, no differences in skin or muscular blood flow could be detected between propranolol, a non‐selective β 2 ‐adrenoceptor blocker and metoprolol, a β 1 ‐adrenoceptor blocker .…”

Section: Introductionmentioning

confidence: 99%

Peripheral vasoconstriction induced by β‐adrenoceptor blockers: a systematic review and a network meta‐analysis

Khouri

Jouve

Blaise

et al. 2016

Brit J Clinical Pharma

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AIMPeripheral vasoconstriction has long been described as a vascular adverse effect of β-adrenoceptor blockers. Whether β-adrenoceptor blockers should be avoided in patients with peripheral vascular disease depends on pharmacological properties (e.g. preferential binding to β 1 -adrenoreceptors or intrinsic sympathomimetic activity). However, this has not been confirmed in experimental studies. We performed a network meta-analysis in order to assess the comparative risk of peripheral vasoconstriction of different β-adrenoceptor blockers. METHODWe searched for randomized controlled trials (RCTs) including β-adrenoceptor blockers that were published in core clinical journals in the Pubmed database. All RCTs reporting peripheral vasoconstriction as an adverse effect of β-adrenoceptor blockers and controls were included. Sensitivity analyses were conducted including possibly confounding covariates (latitude, properties of the β-adrenoceptor blockers, e.g. intrinsic sympathomimetic activity, vasodilation, drug indication, drug doses). The protocol and the detailed search strategy are available online (PROSPERO registry CRD42014014374). RESULTSAmong 2238 records screened, 38 studies including 57 026 patients were selected. Overall, peripheral vasoconstriction was reported in 7% of patients with β-adrenoceptor blockers and 4.6% in the control groups (P < 0.001), with heterogeneity among drugs. Atenolol and propranolol had a significantly higher risk than placebo, whereas pindolol, acebutolol and oxprenolol had not. CONCLUSIONOur results suggest that β-adrenoceptor blockers have variable propensity to enhance peripheral vasoconstriction and that it is not related to preferential binding to β 1 -adrenoceptors. These findings challenge FDA and European recommendations regarding precautions and contra-indications of use of β-adrenoceptor blockers and suggest that β-adrenoceptor blockers with intrinsic sympathomimetic activity could be safely used in patients with peripheral vascular disease. British Journal of Clinical Pharmacology WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT• β-adrenoceptor blockers are known to induce peripheral vasoconstriction, probably according to their pharmacological properties (e.g. preferential binding to β1-adrenoreceptors, intrinsic sympathomimetic activity or vasodilator effect). However, this has never been confirmed in experimental studies. WHAT THIS STUDY ADDS• Our results suggest that β-adrenoceptor blockers have variable propensity to enhance peripheral vasoconstriction. Moreover, ancillary properties of β-adrenoceptor blockers widely influence this peripheral vasoconstriction: ISA and vasodilator effect are protective, whereas preferential binding to β1-adrenoreceptors does not protect from peripheral vasoconstriction.• These findings challenge FDA and French recommendations regarding precautions and contra-indications of use of β-adrenoceptor blockers, and suggest that β-adrenoceptor blockers with intrinsic sympathomimetic activity could be safely used in patients with Raynaud's phenomenon.

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Through/Peak Ratios of Once Daily Angiotensin Converting Enzyme Inhibitors and Calcium Antagonists

Zannad

Matzinger

Larché

1996

American Journal of Hypertension

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Medications given once daily may increase compliance for treatment of hypertension, if the drugs have a prolonged duration of action. The time-effect profiles for antihypertensive drugs may not depend entirely on pharmacokinetic measurements (plasma levels). Thus, trough/peak effects on blood pressure should be measured. It has been suggested that trough/peak ratios be greater than 50% for optimal 24-h control of pressure. Because very little information is available for many angiotensin converting enzyme (ACE) inhibitors and calcium antagonists concerning their trough/peak ratios and awaiting prospective comparative trials with adequate methodology, we have analyzed the duration of action of blood pressure lowering during long-term therapy with commercially available ACE inhibitors and calcium antagonists in published studies that used ambulatory blood pressure monitoring. Published studies were searched in scientific databases using relevant key words. Twenty-four ACE inhibitor and 34 calcium antagonist studies with comparable methodologies were selected. The mean trough/ peak ratios were computed after reconstruction of the curve of the magnitude of blood pressure changes against time. The results showed that once daily administration of ACE inhibitors produced on average ratios higher than 50% with fosinopril (64%), ramipril (50% to 63%), and trandolapril (50% to 100%). Other studied ACE inhibitors produced ratios on average equal to [enalapril (40% to 64%), cilazapril (10% to 80%), lisinopril (30% to 70%)] or significantly lower than 50% [captopril (25%), benazepril (40%), perindopril (35%), quinapril (10% to 40%), and moexipril (0% to 9%)]. As for once daily calcium antagonists, amlodipine (50% to 100%), lacidipine (40% to 100%), nifedipine Coat-Core (50% to 69%), nifedipine gastrointestinal therapeutic system (GITS) (60% to 94%), as well as various "slow release" formulations of diltiazem (20% to 80%) and verapamil (45% to 100%) had on average ratios higher than 50% whereas felodipine ER (30% to 45%), various slow release formulations of isradipine (10% to 80%), and nitrendipine (10% to 80%) had ratios lower than 50%. Although this retrospective literature analysis may have some theoretical limitations, it suggests that not all once daily ACE inhibitors and calcium antagonists cause trough/peak ratio superior to 50%. This may have important clinical implications.

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Comparison of quinapril and atenolol as single drugs or in combination with hydrochlorothiazide in moderate to severe hypertensives, using automated ambulatory monitoring.

Cited by 6 publications

References 27 publications

Comparative Efficacy of Two Different β‐Blockers on 24‐Hour Blood Pressure Control

Comparative Efficacy of Two Different β‐Blockers on 24‐Hour Blood Pressure Control

Peripheral vasoconstriction induced by β‐adrenoceptor blockers: a systematic review and a network meta‐analysis

Through/Peak Ratios of Once Daily Angiotensin Converting Enzyme Inhibitors and Calcium Antagonists

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