ONCE DAilY PENBUTOlOl OR ATENOlOl SEEMS EFFECTIVE IN HYPERTENSijON

BP reduction may be greater than that seen with antihypertensive combinations The use of single agents in the treatment of essential hypertension has often been dismissed in favour of combinations. Nevertheless, combinations of antihypertensives are more productive of adverse reactions and non-compliance. In a prospective double-blind study, 21 patients with moderate hypertension (BP 160/95mm Hg) were randomly allocated to atenolol 100mg/day or penbutolol 40mg / day for 6 weeks. Almost all of the patients had previously been treated with a combination of a diuretic (usually chlorthalidone) and a ~-blocker (usually propranolol or metoproloI). A 4-week placebo washout period was allowed before the study drugs were tested. BP fell below 150/95mm Hg in 19 patients (90 %). The 2 failures (I on atenolol and I on penbuto\oI) had previously been well controlled by propranolol and chlorthalidone. 6 patients who had been inadequately controlled before the trial by a ~-blocker and a diuretic, were controlled by the single agents (3 on atenolol and 3 on penbutoloI). There were no significant differences in efficacy between the 2 drugs. Penbutolol therapy produced a 23 % mean decrease in pulse rate and atenolol a 30 % decrease. Side effects were similar on penbutolol and atenolol, and included transient nausea, difficulty in sleeping, nervousness and dizziness. Houtzagers, J.J.R. and Chadha, D.R.: Journal of International Medical Research 10: I (No I, 1982)

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