Propranolol in hypertension: a dose-response study.

Galloway, D. B.; Glover, Sophie; Hendry, W. Garden; Logié, Armelle; Petrie, J. C.; Smith, Mark Caleb; Lewis, J A; Simpson, William

doi:10.1136/bmj.2.6028.140

Cited by 31 publications

(8 citation statements)

References 4 publications

(3 reference statements)

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“…This effect may be small and may not represent the maximal response but is quite clearly present on analysis of standing and post-exercise systolic pressures. These observations are consistent with other studies showing rapid hypotensive effects of single doses of propranolol (Galloway et al, 1976) and atenolol (Webster et al, 1984).…”

Section: Discussionsupporting

confidence: 93%

A comparison of single doses of bucindolol and oxprenolol in hypertensive patients.

Webster¹,

Petrie²,

Robb³

et al. 1985

Brit J Clinical Pharma

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Single doses of bucindolol 50, 100 and 200 mg were compared to placebo and single doses of oxprenolol 40, 80 and 160 mg in seven patients with mild hypertension, in a double‐blind randomized study. Both bucindolol and oxprenolol inhibited exercise induced tachycardia. The mean maximum inhibition of exercise heart rate was similar after each dose of both drugs (20%, P less than 0.001). Bucindolol produced a significantly greater reduction in blood pressure than either oxprenolol or placebo. This was most apparent in standing systolic and diastolic and post‐ exercise systolic blood pressures between 1 and 2 h after dosing and was dose‐related. All seven patients experienced adverse effects related to hypotension within the first 2 h after ingestion of bucindolol 200 mg. Plasma concentrations of oxprenolol, bucindolol or 5‐ hydroxy‐bucindolol, sampled 2 h after dosing, could not be related to either the changes in blood pressure or to the occurrence of symptoms. The results emphasise the need for careful dose‐finding of new drugs prior to their more widespread evaluation in phase 3 studies.

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Section: Discussionsupporting

confidence: 93%

A comparison of single doses of bucindolol and oxprenolol in hypertensive patients.

Webster¹,

Petrie²,

Robb³

et al. 1985

Brit J Clinical Pharma

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“…Different formulations are available. 26 . 30 The long-acting ones allow it to be administered once-daily despite its short half-life in plasma (1-6 h).…”

Section: Disadvantagesmentioning

confidence: 95%

Drug treatment: present and future

Lyons

Petrie

Reid

1994

British Medical Bulletin

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The objectives of drug therapy--present and future--for the treatment of raised blood pressure are to prevent the morbid and fatal events which arise in individual patients as a consequence of poorly controlled levels of elevated systolic and/or diastolic blood pressure. The target levels of blood pressure require to be achieved without adverse effects at an affordable cost, over a prolonged period of years. The factors affecting the choice of drugs in such patients include the 'profiling' of the blood pressure to assess the severity of the hypertension, associated diseases and risk factors, concurrent therapy, inter-individual variations in response between patients and cost-effectiveness.

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“…For instance, there is dispute about the dose range to be employed with the most used agents, propranolol and oxprenolol. Dose ranges for propranolol have been quoted from 10 to 4000 mg daily (Prichard and Gillam, 1969), whereas in a recent study no benefit from doubling the dose from 120 to 240 mg daily was found (Galloway et al, 1976). Our initial studies with oxprenolol (Marshall and Barritt, 1973;Barritt et al, 1976) adopted a dose range from 160 to 1280 mg daily, but analysis of the dose response suggested that there was no demonstrable benefit from higher dosage.…”

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confidence: 89%

Beta blockade in essential hypertension: an analysis of response to oxprenolol.

Barritt¹,

Marshall²

1977

Heart

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The data from 40 patients with essential hypertension treated with oxprenolol alone have been used to analyse the falls of blood pressure and heart rate. Blood pressure and heart rate did not fallfurther as the daily dose was increased above 160 mg. The range offall in mean pressure was from 0 to 40 mmHg and there was no clear separation into response groups. Pressure falls were unrelated to sex, age, initial heart rate, increase in heart rate on standing, the fall of heart rate with the drug, or the initial height of blood pressure. In the absence of predicting factors the use of oxprenolol, and, by deduction, other beta blocking agents, in hypertension remains empirical, but the simplification of the dose range allows the response to oxprenolol to be determined quickly.All beta blocking drugs which have been tested in hypertension have been shown to have a hypotensive effect. In two trials propranolol, practolol, oxprenolol, metoprolol, timolol, pindolol, alprenolol, and tolamolol were found to be effective hypotensive agents (Morgan et al., 1974;Davidson et al., 1976), and it appears to be the case that the possession of attributes such as cardioselectivity, intrinisic sympathomimetic activity, and membrane stabilising activity are irrelevant in this respect.Several important aspects of the use of beta blockade await clear definition. For instance, there is dispute about the dose range to be employed with the most used agents, propranolol and oxprenolol. Dose ranges for propranolol have been quoted from 10 to 4000 mg daily (Prichard and Gillam, 1969), whereas in a recent study no benefit from doubling the dose from 120 to 240 mg daily was found (Galloway et al., 1976 Patients and methodsForty patients with essential hypertension were studied. The mean systolic blood pressure was 175 SD ± 20 and diastolic 111 SD ± 9 mmHg. The trials in which they took part have previously been reported (Marshall and Barritt, 1973;Barritt et al., 1976). Seventeen were men, and 23 were women, and their age range was from 30 to 73 years. Renal disease was excluded by examining the abdomen, testing the urine for albumin, and measuring blood urea and electrolytes. Endocrine hypertension was excluded by clinical examination and measurement of urinary catecholamine excretion. The presence of obstructive airways disease, cardiac failure, or hypertensive complications requiring immediate treatment, were reasons for exclusion. All the patients were new hypertensives who had received no previous treatment, and received no other hypotensive agent during the period of study.After the initial assessment they attended a clinic specially set aside for the study. Every patient attended this clinic on 4 occasions at weekly intervals before starting treatment. Each patient was seen throughout by the same physician and the blood pressure was measured blindly using the London School of Hygiene and Tropical Medicine sphygmomanometer. Blood pressure was measured after 5 825

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Propranolol in hypertension: a dose-response study.

Cited by 31 publications

References 4 publications

A comparison of single doses of bucindolol and oxprenolol in hypertensive patients.

A comparison of single doses of bucindolol and oxprenolol in hypertensive patients.

Drug treatment: present and future

Beta blockade in essential hypertension: an analysis of response to oxprenolol.

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