Document Detail


Comparison of a chronotherapeutically administered beta blocker vs. a traditionally administered beta blocker in patients with hypertension.
MedLine Citation:
PMID:  16015049     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Increasing systolic blood pressure and heart rate during the early morning results in increased myocardial oxygen demand. The use of beta blockers during this period may decrease cardiac workload, particularly in beta-blocker sensitive patients. The impact of a new chronotherapeutic beta blocker was assessed in 44 hypertensive patients. Patients were randomized to delayed-release propranolol (INP) dosed at 10 p.m. or to traditionally dosed propranolol (ILA) dosed at 8 a.m. for 4 weeks, following which they were switched to the alternative formulation for 4 weeks. Thirty-four-hour ambulatory blood pressure monitoring and pharmacokinetic measurements were obtained. INP and ILA resulted in significant reductions in mean 24-hour blood pressure (-9.0/-6.9 mm Hg and -10.4/-7.7 mm Hg, respectively). The top 25% of responders to high-dose propranolol (sensitive patients) were compared on each formulation. Mean trough reductions were -8.0/-6.7 mm Hg and -7.6/-5.8 mm Hg, respectively. Mean blood pressure reductions in the beta-blocker sensitive patients (n = 11) between 6 a.m. and noon were -15.2/-11.9 mm Hg on INP and -8.0/-4.6 mm Hg on ILA. Heart rate reduction was -14.1 bpm and double product reduction was -3319 in the INP patients between 6 a.m. and 12 noon compared with -10.5 and -2209 in the ILA patients. This study suggests that INP and ILA are effective once-a-day beta blockers, but the use of delayed-release propanolol results in a greater reduction in double product between 6 a.m. and noon in beta-blocker sensitive patients than does traditionally dosed propranolol.
Authors:
Joel M Neutel; Keith Rotenberg
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Publication Detail:
Type:  Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of clinical hypertension (Greenwich, Conn.)     Volume:  7     ISSN:  1524-6175     ISO Abbreviation:  J Clin Hypertens (Greenwich)     Publication Date:  2005 Jul 
Date Detail:
Created Date:  2005-07-14     Completed Date:  2006-03-02     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  100888554     Medline TA:  J Clin Hypertens (Greenwich)     Country:  United States    
Other Details:
Languages:  eng     Pagination:  395-400; quiz 401-2     Citation Subset:  IM    
Affiliation:
Orange County Research Center, Tustin, CA 92780, USA. jmneutel@aol.com
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adrenergic beta-Antagonists / administration & dosage*,  pharmacokinetics,  therapeutic use
Adult
Aged
Antihypertensive Agents / administration & dosage*,  pharmacokinetics,  therapeutic use
Area Under Curve
Blood Pressure / drug effects*
Blood Pressure Monitoring, Ambulatory
Cross-Over Studies
Delayed-Action Preparations
Double-Blind Method
Female
Heart Rate / drug effects
Humans
Hypertension / drug therapy*
Male
Middle Aged
Propanols / administration & dosage*,  pharmacokinetics,  therapeutic use
Propranolol / administration & dosage*,  pharmacokinetics,  therapeutic use
Chemical
Reg. No./Substance:
0/Adrenergic beta-Antagonists; 0/Antihypertensive Agents; 0/Delayed-Action Preparations; 0/Propanols; 0/propranolol CR; 525-66-6/Propranolol

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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