TREATMENT OF ARTERIAL-HYPERTENSION WITH THE SELECTIVE BETA-ADRENERGIC-RECEPTOR BLOCKER TALINOLOL

Beta adrenergic receptor blockers are among the few drugs which have b een shown to reduce cardiac morbidity and mortality in patients with h ypertension, Talinolol, a cardioselective beta blocker without intrins ic sympathomimetic activity, was introduced in 1975. We investigated t alinolol in 113 patients (81 men and 32 women aged 18-52 years) with h ypertension, The patients were selected on the basis of suitability fo r beta blocker treatment; asthmatics and patients with severe heart fa ilure and claudication were excluded, The hemodynamic effects were ass essed,vith xenon-133 muscle clearance, roentgenography, and echocardio graphy, as well as hand-grip tests and bicycle ergometry, Cardiac outp ut decreased with treatment, primarily because of a reduced heart rate which was most pronounced with exercise, Cardiac output related to de creased heart rate was also observed in persons who did not respond wi th a decrease in blood pressure, After 3 months treatment, a decrease in left ventricular mass was detected,vith echocardiography, We also c ompared talinolol with propranolol in a double-blind fashion and obser ved a lower stress-induced increase in diastolic blood pressure with t alinolol compared to propranolol, Platelet aggregation was studied bef ore talinolol administration in these patients and was found to be inc reased, Talinolol treatment was associated with a decrease in platelet aggregation, while the platelet response to the agonists ADP, adrenal in, and collagen was not affected, Fifty-five patients were treated fo r periods of 3 months to 7 years; systolic and diastolic blood pressur e decreased by 11 and 12 per cent respectively, The doses required for this effect ranged from 100 to 300 mg/day, Doses higher than 300 mg/d ay did not reduce blood pressure further, Total cholesterol and fastin g blood sugar decreased with treatment, while the serum potassium conc entration increased slightly, No serious side effects were observed an d the drug was not discontinued in any patient, Talinolol compared fav orably to nifedipine treatment, A combination of the two drugs was ass ociated with a further decrease in blood pressure, We conclude that ta linolol is an effective antihypertensive beta blocker.