metoprolol vs atenolol and propranolol in hypertension

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Metoprolol vs Atenolol and Propranolol in Hypertension Metoprolol is more cost-effective, but atenolol has fewer side effects 32 patients, in whom BP was controlled with propranolol, were randomly allocated to treatment with equivalent doses of atenolol and metoprolol for 8-12 weeks in this open, crossover study. Propranolol 106 and 110 mg/day was equivalent in antihypertensive effect to 54 and 120 mgjday of atenolol and metoprolol, respectively. Metoprolol 114 mgjday was equivalent to 53 mgjday of atenolol, although the diastolic BP was significantly lower during metoprolol therapy (86 vs 81 mm Hg). The most commonly reported side effects were malaise, mental torpor, impotence, dreams and gastrointestinal effects. The incidence of side effects in patients taking atenolol was about 50% of that in patients taking propranolol and metoprolo/. Two patients on atenolol were withdrawn because of diarrhoea and irritability with profuse sweating. One patient on metoprolol was withdrawn because of malaise and light- headedness. Based on wholesale prices of 1 year's treatment at the mean daily doses used in this study, the cost of treatment with metoprolol was about 50% of that with propranolol or ate nolo/' Thus, in the treatment of essential hypertension with i3-blockers ' ... the most cost-effective approach is to initiate therapy with metoprolol and to change to atenolol if side effects develop'. Haley, R.J et aJ.- Current Therapeutic Research 36: 993 (Nov 1984) 0156-2703/84/1215-0011/0$01.00/0 © ADIS Press INPHARMA® 15 Dec 1984 11

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Page 1: Metoprolol vs Atenolol and Propranolol in Hypertension

Metoprolol vs Atenolol and Propranolol in Hypertension Metoprolol is more cost-effective, but atenolol has fewer side effects

32 patients, in whom BP was controlled with propranolol, were randomly allocated to treatment with equivalent doses of atenolol and metoprolol for 8-12 weeks in this open, crossover study. Propranolol 106 and 110 mg/day was equivalent in antihypertensive effect to 54 and 120 mgjday of atenolol and metoprolol, respectively. Metoprolol 114 mgjday was equivalent to 53 mgjday of atenolol, although the diastolic BP was significantly lower during metoprolol therapy (86 vs 81 mm Hg).

The most commonly reported side effects were malaise, mental torpor, impotence, dreams and gastrointestinal effects. The incidence of side effects in patients taking atenolol was about 50% of that in patients taking propranolol and metoprolo/. Two patients on atenolol were withdrawn because of diarrhoea and irritability with profuse sweating. One patient on metoprolol was withdrawn because of malaise and light­headedness.

Based on wholesale prices of 1 year's treatment at the mean daily doses used in this study, the cost of treatment with metoprolol was about 50% of that with propranolol or ate nolo/' Thus, in the treatment of essential hypertension with i3-blockers ' ... the most cost-effective approach is to initiate therapy with metoprolol and to change to atenolol if side effects develop'. Haley, R.J et aJ.- Current Therapeutic Research 36: 993 (Nov 1984)

0156-2703/84/1215-0011/0$01.00/0 © ADIS Press INPHARMA® 15 Dec 1984 11