Titre du document / Document title

Low-dose α/β blockade in the treatment of essential hypertension

Auteur(s) / Author(s)

MANN Samuel J. ⁽¹⁾ ; GERBER Linda M. ⁽¹⁾ ;

Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)

⁽¹⁾ New York Presbyterian Hospital, Weill Medical College of Cornell University, New York, New York, ETATS-UNIS

Résumé / Abstract

Despite the recent emphasis on combination drug therapy for hypertension, little attention has been given to α/β blockade using agents other than labetalol. The purpose of this study was to 1) compare the efficacy of low-dose α/β blockade using doxazosin + betaxolol, versus monotherapy with an angiotensin converting enzyme inhibitor (quinapril) and a diuretic (hydrochlorothiazide [HCTZ]), and 2) assess the efficacy of low-dose doxazosin. In a crossover study, 21 hypertensive subjects were treated for 3 weeks each with HCTZ, 12.5 to 25 mg/day, quinapril, 10 to 40 mg/day, and a combination of doxazosin, 1 to 4 mg + betaxolol, 5 to 10 mg daily. Doses were titrated to achieve a systolic pressure < 130 mm Hg, as assessed by self-recorded home measurements. Home blood pressure decreased 11.5/7.5 mm Hg after HCTZ, 12.9/8.8 mm Hg after quinapril, and 21.2/16.5 mm Hg after doxazosin + betaxolol (P <.001/<.001 v HCTZ and P <.002/<.001 v quinapril). The target systolic pressure was achieved by 33%, 43%, and 71% of subjects, respectively (P =.04 v HCTZ, and.03 v quinapril). Among the 8 subjects in whom doxazosin dosage was increased to the maximum of 4 mg, the mean blood pressure achieved at 4 mg did not differ from that achieved at 2 mg (136/87 v 136/88 mm Hg). We conclude that oral α/β blockade is superior to monotherapy with an angiotensin converting enzyme inhibitor or a diuretic and that maximal or near maximal efficacy can be achieved at a 2-mg dose of doxazosin. Low-dose oral α/β blockade merits greater consideration in the drug therapy of essential hypertension.

Revue / Journal Title

American journal of hypertension   ISSN 0895-7061 

Source / Source

2001, vol. 14 (1), n^o6, pp. 553-558 (28 ref.)

Langue / Language

Anglais

Editeur / Publisher

Elsevier Science, New York, NY, ETATS-UNIS  (1988) (Revue)

Mots-clés anglais / English Keywords

Hypertension ; Doxazosin ; Alpha blocking agent ; Low dose ; Betaxolol ; Beta blocking agent ; Quinapril ; Peptidyl-dipeptidase A ; Enzyme inhibitor ; Hydrochlorothiazide ; Diuretic ; Chemotherapy ; Treatment ; Drug combination ; Treatment efficiency ; Human ; Arterial pressure ; Antihypertensive agent ; Thiazide ; Peptidyl-dipeptidases ; Peptidases ; Hydrolases ; Enzyme ; Cardiovascular disease ;

Mots-clés français / French Keywords

Hypertension artérielle ; Doxazosine ; Bloquant α-adrénergique ; Dose faible ; Bétaxolol ; Bloquant β-adrénergique ; Quinapril ; Peptidyl-dipeptidase A ; Inhibiteur enzyme ; Hydrochlorothiazide ; Diurétique ; Chimiothérapie ; Traitement ; Association médicamenteuse ; Efficacité traitement ; Homme ; Pression artérielle ; Antihypertenseur ; Thiazide ; Angiotensin converting enzyme ; Peptidyl-dipeptidases ; Peptidases ; Hydrolases ; Enzyme ; Appareil circulatoire pathologie ;

Mots-clés espagnols / Spanish Keywords

Hipertensión arterial ; Doxazosina ; Bloqueador α-adrenérgico ; Dosis débil ; Betaxolol ; Bloqueador β-adrenérgico ; Quinapril ; Peptidyl-dipeptidase A ; Inhibidor enzima ; Hidroclorotiazida ; Diurético ; Quimioterapia ; Tratamiento ; Asociación medicamentosa ; Eficacia tratamiento ; Hombre ; Presión arterial ; Antihipertensivo ; Tiazida ; Peptidyl-dipeptidases ; Peptidases ; Hydrolases ; Enzima ; Aparato circulatorio patología ;

Localisation / Location

INIST-CNRS, Cote INIST : 21579, 35400009650053.0090