Summary
Intra-arterial ambulatory blood pressure was measured over a 24-hour period in 34 patients with untreated hypertension then randomised to either atenolol, metoprolol, pindolol, or long acting propranolol. A second intra-arterial recording was made after the drugs had been taken once daily for 3 to 8 months and was started 4 hours after the last dose. Atenolol (mean dose 128mg) significantly lowered mean arterial pressure for all 24/24 recorded hours, metoprolol (311mg) for 12/24h, pindolol (33mg) for 15/24h and long acting propranolol (45 7mg) for 22/24h. Atenolol and long acting propranolol reduced the variability of systolic blood pressure. Significant bradycardia was seen with atenolol for 20/24h, metoprolol for 20/24h, pindolol for 10/24h and long-acting propranolol for 24/24h.
Atenolol and long acting propranolol are effective antihypertensive agents when taken once daily; metoprolol and pindolol need to be given more frequently, although pindolol, having partial agonist activity, may raise heart rate and attenuate the fall in blood pressure during sleep.
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Floras, J.S., Hassan, M.O., Jones, J.V. et al. Ambulatory Blood Pressure and its Variability During Randomised Double-blind Administration of Atenolol, Metoprolol, Pindolol and Long Acting Propranolol in Subjects with Mild to Moderate Hypertension. Drugs 25 (Suppl 2), 19–25 (1983). https://doi.org/10.2165/00003495-198300252-00005
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DOI: https://doi.org/10.2165/00003495-198300252-00005