Abstract
In order to decide whether beta-blockers or calcium antagonists are preferable as initial antihypertensive therapy, we investigated the efficacy of monotherapy with oxprenolol (160 mg once daily) and nitrendipine (20 mg once daily) in a single-blind randomized study. Only male civil servants with mild hypertension were included (\(\overline x \) = 43±6years of age; n=92). Clinical casual blood pressure (BP) was lowered equally in both groups, as was average BP at work, as assessed by ambulatory BP monitoring with Remler M2000 (123 ±12/81 ±14 vs. 129± 17/80 ± 10mmHg). This was done after casual BP had been within the normotensive range for 3 months. At equal levels of self-reported arousal and physical activity, systolic BP was lower in patients receiving oxprenolol. In the nitrendipine group, 24% discontinued therapy because of side effects, whereas only 12% receiving oxprenolol initially reported intolerable side effects. Patients on a regimen of oxprenolol reported less intense Type A characteristics in questionnaires administered after 3 months of therapy.
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References
Dembroski TM, McDougall JM, Musante L (1979) The structured interview and questionnaire methods of assessing coronary–prone behavior in male and female college students. J Behav Med 2: 71–83
Eliot RS, Buell JC (1983) The role of the CNS in cardiovascular disorders. Hosp Pract 18: 189–199
Franz EW (1980) Differential antihypertensive effect of acebutolol and hydrochlorothiazide/amiloride hydrochloride combination on elevated exercise blood pressure in hypertensive patients. Am J Cardiol 46: 301–305
Hines EA, Brown GE (1936) The cold pressor test measuring the reactivity of the blood pressure: data concerning 571 normal and hypertensive subjects. Am Heart J11: 1–9
Hypertension Detection and Follow Up Program Cooperative Group (1979) Five-year findings of the Hypertension Detection and Follow Up Program. I. Reduction in mortality of persons with high blood pressure, including mild hypertension. JAMA 242: 2572–2577
Julius S (1978) Borderline hypertension: clinical and pathophysiological significance. Adv Intern Med Pediatr 41: 51–84
Julius S (ed) (1984) Pharmamanual. A comprehensive guide to the therapeutic use of Trasicor®. Karger, Basel
Kannel WB, Gordon T, Schwartz MJ (1971) Systolic versus diastolic blood pressure and risk of coronary disease. Am J Cardiol 27: 335
Krantz D (1984) Behavioral effects of beta–blockers. In: Zanchetti A, Turner P (eds) Selected topics of cardiovascular drug therapy. Springer, Berlin Heidelberg New York Tokyo
Krantz DS, Durel LA, Davia JE, Shafter RT, Arabian JM, Dembroski TM, McDougall JM (1982) Propranolol among coronary patients: relationship to Type A behavior and cardiovascular response. J Human Stress 8: 4–12
Lund–Johansen P (1974) Hemodynamic changes at rest and during exercise in long-term beta-blocker therapy of essential hypertension. Acta Med Scand 195: 117–121
Man in t Veld AJ, Schalekamp MADH (1982) How intrinsic sympathomimetic activity modulates the haemodynamic responses to adrenoceptor antagonists. A clue to the nature of their antihypertensive mechanism. Br J Clin Pharmacol 13: 245S–257S
Matthews KA (1982) Psychological perspectives on the Type A behavior pattern. Psychol Bull 91: 293–329
Miller-Craig MW, Mann S, Bala Subramanian V, Altman DG, Raftery EB (1983) The effects of Oxprenolol on ambulatory intra–arterial blood pressure in essential hypertension. Eur J Clin Pharmacol 24: 713–721
Neus H, von Eiff AW, Friedrich G, Heusch G, Schulte W (1981) Das Problem der Adaptation in der klinisch-therapeutischen Hypertonieforschung. Dtsch Med Wochenschr 106: 622–624
Neus H, von Eiff AW, Friedrich G, Rüddel H, Schulte W (1983) The influence of beta-blockers and diuretics on blood pressure response. Z Kardiol 72: 617–621
Neus H, Gogolin E, Langewitz W, von Eiff AW (1984) Intermittent ambulatory blood pressure recordings in children. Methodological aspects and influence of family history on hypertension. Klin Wochenschr 62
Noffke H-U, Schirmer G (1981) Indirekte Blutdruckmessung mit einem Zwei-Sonden-Ultraschall-System. Biomed Tech 26: 162–167
Perloff D, Sokolow M, Cowan R (1983) The prognostic value of ambulatory blood pressures. JAMA 249: 2792–2798
Rüddel H, McKinney ME, Buell JC, Eliot RS (1984 a) Reliabilität des cold pressor tests. Herzmedizin 7: 39–43
Rüddel H, Schmieder R, Langewitz W, Neus J, Wagner O, von Eiff AW (1984b) Efficacy of nitrendipine as baseline antihypertensive therapy. J Cardiovasc Pharmacol 6: 114–116
Rüddel H, Neus H, Langewitz W, Schulte W, von Eiff AW ( 1984 c) Mental stress testing in the physician’s office and in the field. In: Steptoe A, Rüddel H, Neus H (eds) Applied cardiovascular psychophysiology. Springer, Berlin Heidelberg New York Tokyo: 66–76
Rüddel H, Schmieder R, von Eift AW ( 1986 a) Wirkung einer Langzeit-Monotherapie mit Nitrendipin auf hämodynamische Veränderungen unter psychischer Belastung. In: Distler A (Ed) Calciumantagonisten in der Hochdruck–Therapie. Schattauer Verlag, Stuttgart: 163–178
Rüddel H, Schmieder R, Langewitz W, Otten H (1986 b) Effect of antihypertensive therapy with beta–blockers on type A behavior and hostility. Psychosom Med 48: 295 (abstract)
Schmieder R, Neus H, Friedrich G, Rüddel H, von Eiff AW (1983 a) The influence of beta–blockers on cardiovascular reactivity and Type A behavior pattern in hypertensives. Psychosom Med 45: 417–423
Schmieder R, Neus H, Friedrich G, Rüddel H (1983 b) blockers and Type A behavior. Long-term effect and methodological problems. Psychophysiology 20:470 (abstract)
Schmieder R, Rüddel H, Langewitz W, Neus J, Wagner O, von Eiff AW (1985) The influence of monotherapy with Oxprenolol and Nitrendipine on ambulatory blood pressure in hypertensives. J Clin Exp Hypertension A7: 445–454
Schmieder RE, Rüddel H, Neus M, Messerli FH, von Eift AW (1986) Disparate hemodynamic response to mental challenge after antihypertensive therapy with beta blockers and calcium entry blockers. Am J Med (to be published )
Schulte W, Neus H (1984) Hemodynamics during emotional stress in borderline and mild hypertension. Eur Heart J 4: 803–809
Steptoe A (ed) (1984) Report of the discussion meeting on current research on the Type A behavior pattern in Europe. Concerted action “breakdown in human adaptation”. Commission of the European Communities, Medical and Public Health Research Programme, Brussels
Stoepel K, Deck K, Ingram C, Corsing SH, Vanov SK (1984) Safety aspects of long term nitrendipine therapy. J Cardiovasc Pharmacol 6 (suppl 7): S1072–1075
Taylor SH (1983) Oxprenolol in clinical practice. Am J Cardiol 52: 340–420
The Management Committee (1980) The Australian therapeutic trial in mild hypertension. Lancet 1: 1261–1267
von Eiff AW, Neus H (1980) Verkehrslärm und Hypertonie–Risiko. Erste Mitteilung. MMW 122: 894–896
von Eiff AW, Friedrich G, Langewitz W, Neus H, Rüddel H, Schirmer G, Schulte W (1981) Ver–kehrslärm und Hypertonie–Risiko. Hypotholamus-Theorie der essentiellen Hypertonie. Zweite Mitteilung. MMW 123: 420–423
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Rüddel, H. et al. (1986). Biobehavioral Effects of Antihypertensive Monotherapy: Oxprenolol and Nitrendipine. In: Schmidt, T.H., Dembroski, T.M., Blümchen, G. (eds) Biological and Psychological Factors in Cardiovascular Disease. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-71234-0_37
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DOI: https://doi.org/10.1007/978-3-642-71234-0_37
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