A DOUBLE-BLIND COMPARISON OF BISOPROLOL AND ATENOLOL IN PATIENTS WITHESSENTIAL-HYPERTENSION

We compared the beta(1)-selective adrenoceptor antagonists bisoprolol and atenolol in a double-blind, randomized crossover study. After 4 we eks placebo phase, 59 patients with essential hypertension received ei ther 10 mg bisoprolol or 50 mg atenolol once daily for 8 weeks, increa sed if necessary (target BP less than or equal to 150/90 mmHg) to 20 a nd 100mg, respectively, after 4 weeks. After a second placebo phase, c rossover occurred to the alternative drug. We measured resting systoli c and diastolic blood pressures and heart rate at 24 h post-dose basel ine and after 4 and 8 weeks treatment. Both drugs significantly lowere d systolic and diastolic blood pressures and heart rate at 8 weeks com pared to baseline (all p<0.05). Bisoprolol reduced heart rate signific antly more than atenolol (p< 0.01), but systolic and diastolic blood p ressure changes were not different between the two drugs. There was no difference in patient acceptability of the drugs as assessed by visua l analogue scale. Despite theoretical and circumstantial evidence to s uggest superiority of bisoprolol over atenolol, no significant differe nce between the two was found except for greater heart rate reduction with bisoprolol.