Beta-blockers: once or three times a day?

In a double-blind, crossover trial 16 hypertensive patients were treated, in random order, with placebo, metoprolol 300 mg in a single daily dose, or metoprolol 300 mg/day in three doses. Both therapeutic regimens produced detectable plasma metoprolol concentrations and appreciable beta-blockade, es...

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Bibliographic Details
Published in:BMJ 1978-05, Vol.1 (6124), p.1386-1388
Main Authors: Reybrouck, T, Amery, A, Fagard, R, Jousten, P, Lijnen, P, Meulepas, E
Format: Article
Language:English
Subjects:
Adult
Blood plasma
Blood pressure
Clinical Trials as Topic
Diastolic blood pressure
Dosage
Double-Blind Method
Drug Administration Schedule
Female
Heart Function Tests
Heart rate
Humans
Hypertension
Hypertension - drug therapy
Male
Medical treatment
Metoprolol - administration & dosage
Metoprolol - blood
Metoprolol - therapeutic use
Middle Aged
Physical Exertion
Placebos
Propanolamines - administration & dosage
Stress tests
Writing tablets
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Summary:In a double-blind, crossover trial 16 hypertensive patients were treated, in random order, with placebo, metoprolol 300 mg in a single daily dose, or metoprolol 300 mg/day in three doses. Both therapeutic regimens produced detectable plasma metoprolol concentrations and appreciable beta-blockade, estimated from exercise tachycardia, throughout the day. Fluctuations throughout the day in plasma drug concentrations and degree of beta-blockade were insignificant on the thrice-daily regimen, but they varied considerably on the single-dose regimen. Both therapeutic regimens also significantly lowered blood pressure throughout the day. Although the thrice-daily regimen again tended to produce a stronger and less fluctuating hypotensive action, the differences in hypotensive effect between the two regimens were not statistically significant. A single-dose of 300 mg of metoprolol can therefore be recommended if the only aim is to reduce blood pressure but not if a steady degree of beta-blockade is needed.
ISSN:0007-1447
0959-8138
1468-5833
DOI:10.1136/bmj.1.6124.1386