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1 Six elderly patients with established hypertension and six young healthy subjects were studied after 8 days of treatment with atenolol 50 mg day-1, metoprolol 50 mg day-', oxprenolol 80 mg day-' and propranolol 80 mg day-1. 2 The area under the blood concentration-time curve was increased in the elderly group for each drug, but the difference was statistically significant only for atenolol. 3 The lower serum albumin concentrations in the elderly group did not result in a decrease in the percentage of propranolol or oxprenolol bound to serum proteins.

WOOD AJJ, WOOD M. The effect of advancing age on the sympathetic response to laryngoscopy and tracheal intubation. Anesth Analg 1989;68:603-8.

The effect of once-daily dosage of the two most widely prescribed cardioselective beta-adrenoceptor antagonists used to treat hypertension-namely, atenolol and metoprolol-was studied in nine carefully selected hypertensive outpatients. Each patient received atenolol 50 mg/ day, atenolol 100 mg/day, metoprolol 100 mg/day, and metoprolol 200 mg/day in a sustained-release formulation (as Lopresor SR) according to a randomised sequence. After three weeks' treatment with each drug given once daily comparisons of the treatments 24 hours after dosing showed no important differences between 50 and 100 mg atenolol/day. Metoprolol, as both the standard and the slow-release formulations, had some limitations in controlling systolic blood pressure and heart rate.These results suggest that the recommendations for the treatment of hypertension with these cardioselective beta-adrenoceptor antagonists should be reconsidered since doses smaller than those recommended are almost as effective and much cheaper.

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