A double-blind comparison of bisoprolol and captopril for treatment of essential hypertension in the elderly

Abstract

The aim of the study was to compare the antihypertensive efficacy and safety of a new beta blocker with high beta 1 selectivity, bisoprolol, with captopril in 28 elderly patients, aged over 65 years, with mild-to-moderate essential hypertension (WHO classes I and II). After a placebo run-in period of 4 weeks, the patients were randomly allocated to receive bisoprolol (5 mg od) or captopril (25 mg bid) (double-dummy technique) for 6 weeks, according to a crossover double-blind design, with a 4-week washout period between the two active treatments. The doses were doubled after 2 weeks if the supine blood pressure was greater than 160/95 mmHg. In basal conditions and after 2, 4, and 6 weeks of each treatment, the blood pressure and heart rate were assessed both in the supine and erect positions. At the same time, the side effects and quality of life were investigated by a checklist and a self-assessment questionnaire. Standard laboratory tests and a resting ECG tracing were performed before and after each active treatment. The data from 24 patients (4 dropouts) showed a significant antihypertensive effect of both treatments (p less than 0.01) with a reduction of diastolic blood pressure to values less than or equal to 95 mmHg in 75% (18/24) of the patients treated with bisoprolol and in 83.3% (20/24) of those treated with captopril, without significant differences between the two drugs. Bisoprolol also produces a marked but symptom-free reduction of heart rate compared with captopril (p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Blockade of the angiotensin system improves mental health domain of quality of life: A meta-analysis of randomized clinical trials

“…To supplement data, attempts to contact the authors of three studies who provided email addresses were made but none replied (Malmqvist et al, 2000; Van Bortel et al, 2005; Weir et al, 2005). Twenty studies did not use a validated scale for measuring QoL and were hence excluded (Bracchetti et al, 1990; Conlin et al, 1998; Croog et al, 1986; Ebert and Kirch, 1999; Fagher et al, 1991; Fletcher et al, 1992; Freytag et al, 2001; Hu and Zhu, 1999; Lacourciere, 1988; Lewis et al, 1996; McMahon et al, 1990; Neaton et al, 1993; Oparil et al, 1996; Paran et al, 1996; Perry et al, 1994; Tanser et al, 2000; Tedesco et al, 1999; Testa et al, 1993; Weir et al, 1996a; Yodfat et al, 1985). One study was excluded as it employed a scale that assessed a purely physical domain of QoL (Ostergren et al, 1996).…”

Therapeutic Properties of Highly Selective β-blockers With or Without Additional Vasodilator Properties: Focus on Bisoprolol and Nebivolol in Patients With Cardiovascular Disease

“…Similar in hypertension: lower central BP on celiprolol [108] -Metoprolol Similar in mild-to-moderate hypertension [109] Greater effect of bisoprolol on BP during exercise in hypertension [110] Similar in hypertension + intermittent claudication [20] RAAS blockers Captopril Similar in elderly patients with hypertension [111] -Lisinopril Similar in hypertension (effects on ambulatory BP) [112] Similar in mild-to-moderate hypertension [113] Similar in hypertension [130] Enalapril Similar in hypertension (office and 24 h BP) [114] Similar in mild-to-moderate hypertension [115] Similar in hypertension [131,132] -BP in hypertensive patients with autonomic failure, a condition that is known to respond to NO [140].…”

Lebensqualität und psychosoziale Faktoren unter antihypertensiver Therapie Ein Vergleich von Captopril und Quinapril bei geriatrischen Patienten

“…wurde nicht Captopril als Vergleichssubstanz mitgeführt [4,11,17,20,26,34]. Durch die aufgezeigte bisherige Überlegenheit gegenüber Enalapril, Propranolol, Atenolol und Methyldopa ist Captopril hingegen als geeignete Referenzmedikation für Untersuchungen der Lebensqualität unter antihypertensiver Therapie anzusehen [6,10,42].…”

“…Hinsichtlich des gefundenen Vorteils von Quinapril ist zu berücksichtigen, dass in bisherigen Vergleichsstudien mit nicht geriatrischen Patienten Captopril anderen ACE-Hemmern und anderen pharmakologischen Klassen in Bezug auf die Lebensqualität überlegen war [6,10,42]. Ein Anstieg der Lebensqualität konnte in der Mehrzahl der Studien für ACE-Hemmer und nur vereinzelt für Betablocker, Diuretika und Calciumantagonisten gefunden werden [1, 9,10,23,28,29,32,39].…”

“…Ein Anstieg der Lebensqualität konnte in der Mehrzahl der Studien für ACE-Hemmer und nur vereinzelt für Betablocker, Diuretika und Calciumantagonisten gefunden werden [1, 9,10,23,28,29,32,39]. Kontrollierte Studien mit älteren Patienten konnten bislang nur für die Substanzen Captopril, Losartan und Telsartan einen Anstieg der Lebensqualität unter Therapie zeigen [6,9,21]. Vor diesem Hintergrund weisen unsere Ergebnisse auf einen mögli-chen Vorteil von Quinapril bei antihypertensiv zu behandelnden geriatrischen Patienten.…”