EFFECTS OF 100 MG OF CONTROLLED-RELEASE METOPROLOL AND 100 MG OF ATENOLOL ON BLOOD-PRESSURE, CENTRAL NERVOUS SYSTEM-RELATED SYMPTOMS, AND GENERAL WELL-BEING

Central nervous system (CNS)-related symptoms and quality of life duri ng treatment with controlled-release (CR) metoprolol and a standard fo rmulation of atenolol were compared in a double-blind crossover study in 60 patients with mild to moderate hypertension. After a 4-week plac ebo run-in period, each beta(1)-adrenoceptor blocker was administered at a dosage of 100 mg once daily for 6 weeks. Quality of life was asse ssed regularly during the active treatment phases by use of two standa rdized self-administered questionnaires, the minor symptom evaluation (MSE) profile, and the psychologic general well-being (PGWB) index. Bo th questionnaires have previously been shown to be effective in detect ing CNS symptoms and changes in well being produced by beta-blockers. Blood pressure and heart rate were monitored to assess the antihyperte nsive efficacy of the two drugs, Metoprolol CR and atenolol produced e quivalent, clinically effective reductions in systolic and diastolic b lood pressures measured 24 hours after administration. The drugs were found to exert similar effects on general well being, as assessed by t he PGWB index, and there were no significant differences between the t wo treatments with regard to the three dimensions of the MSE profile, contentment, vitality, and sleep. Thus, at equivalent antihypertensive dosages, metoprolol CR and atenolol are clinically comparable with re gard to the degree of CNS-related symptoms produced and effects on gen eral well being. Because these agents differ markedly in lipophilicity , other factors, such as beta(1)-selectivity/nonselectivity, may be mo re important determinants of whether these subjective symptoms occur d uring therapy with beta-blockers.