Dilevalol compared to metoprolol for treatment of hypertension

A multicenter trial

B. J. Materson, C. P. Lucas, N. D. Vlachakis, S. Glasser, K Ramanathan, S. Ahmad, J. H. Moreledge, E. Saunders, C. E. Payton, H. W. Schnaper, M. Maxwell

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Dilevalol combines blockade of β-receptors with vasodilation that is mainly due to a β2-agonist activity. This prospective, randomized, double-blind, multicenter trial was carried out in patients with supine diastolic blood pressure (SuDBP) of 95-115 mm Hg. After a 4-week placebo washout phase, 309 patients were randomized to dilevalol and 136 to metoprolol. On a 2- to 8-week titration phase, dilevalol was increased from 200 to 1600 mg once daily or metoprolol from 100 to 400 mg once daily to achieve a SuDBP < 90 mm Hg and ≥ 10 mm Hg decrease from baseline. Responders were followed over a 1 year maintenance phase. The mean patient age was 51 years, 72% were men, and 54% white. The reductions in blood pressure (BP) and heart rte (HR) are shown. The two drugs were similar with regard to percentage of normotensives (60%). Significantly (p = 0.03) more patients discontinued metoprolol due to side effects than dilevalol, specifically for depression and impotence. Nervousness, depression, bradycardia, fatigue, and pruritus were significantly (p < 0.04) more frequent with metoprolol than with dilevalol, as were cold extremities (2% versus <1%). Transaminase levels were elevated from a normal baseline in 2% of patients on dilevalol and in 1% on metoprolol (N.S.) Dilevalol elevated HDL cholesterol by 8.5% with no change in cholesterol or LDL. Triglycerides increased 21 mg/dl with dilevalol and 42 mg/dl with metoprolol. We conclude that both dilevalol and metoprolol are equally effective in lowering BP. Dilevalol appears to have a more favorable safety profile than metoprolol.

Original languageEnglish (US)
JournalJournal of Cardiovascular Pharmacology
Volume11
Issue numberSUPPL. 2
DOIs
StatePublished - Jan 1 1988
Externally publishedYes

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Labetalol
Metoprolol
Multicenter Studies
Hypertension
Blood Pressure
Therapeutics
Depression
Erectile Dysfunction
Pruritus
Bradycardia
Transaminases
Hypercholesterolemia
Vasodilation
LDL Cholesterol
HDL Cholesterol
Fatigue
Triglycerides
Extremities
Anxiety
Placebos

All Science Journal Classification (ASJC) codes

  • Pharmacology
  • Cardiology and Cardiovascular Medicine

Cite this

Dilevalol compared to metoprolol for treatment of hypertension : A multicenter trial. / Materson, B. J.; Lucas, C. P.; Vlachakis, N. D.; Glasser, S.; Ramanathan, K; Ahmad, S.; Moreledge, J. H.; Saunders, E.; Payton, C. E.; Schnaper, H. W.; Maxwell, M.

In: Journal of Cardiovascular Pharmacology, Vol. 11, No. SUPPL. 2, 01.01.1988.

Research output: Contribution to journalArticle

Materson, BJ, Lucas, CP, Vlachakis, ND, Glasser, S, Ramanathan, K, Ahmad, S, Moreledge, JH, Saunders, E, Payton, CE, Schnaper, HW & Maxwell, M 1988, 'Dilevalol compared to metoprolol for treatment of hypertension: A multicenter trial', Journal of Cardiovascular Pharmacology, vol. 11, no. SUPPL. 2. https://doi.org/10.1097/00005344-198800000-00010
Materson, B. J. ; Lucas, C. P. ; Vlachakis, N. D. ; Glasser, S. ; Ramanathan, K ; Ahmad, S. ; Moreledge, J. H. ; Saunders, E. ; Payton, C. E. ; Schnaper, H. W. ; Maxwell, M. / Dilevalol compared to metoprolol for treatment of hypertension : A multicenter trial. In: Journal of Cardiovascular Pharmacology. 1988 ; Vol. 11, No. SUPPL. 2.
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abstract = "Dilevalol combines blockade of β-receptors with vasodilation that is mainly due to a β2-agonist activity. This prospective, randomized, double-blind, multicenter trial was carried out in patients with supine diastolic blood pressure (SuDBP) of 95-115 mm Hg. After a 4-week placebo washout phase, 309 patients were randomized to dilevalol and 136 to metoprolol. On a 2- to 8-week titration phase, dilevalol was increased from 200 to 1600 mg once daily or metoprolol from 100 to 400 mg once daily to achieve a SuDBP < 90 mm Hg and ≥ 10 mm Hg decrease from baseline. Responders were followed over a 1 year maintenance phase. The mean patient age was 51 years, 72{\%} were men, and 54{\%} white. The reductions in blood pressure (BP) and heart rte (HR) are shown. The two drugs were similar with regard to percentage of normotensives (60{\%}). Significantly (p = 0.03) more patients discontinued metoprolol due to side effects than dilevalol, specifically for depression and impotence. Nervousness, depression, bradycardia, fatigue, and pruritus were significantly (p < 0.04) more frequent with metoprolol than with dilevalol, as were cold extremities (2{\%} versus <1{\%}). Transaminase levels were elevated from a normal baseline in 2{\%} of patients on dilevalol and in 1{\%} on metoprolol (N.S.) Dilevalol elevated HDL cholesterol by 8.5{\%} with no change in cholesterol or LDL. Triglycerides increased 21 mg/dl with dilevalol and 42 mg/dl with metoprolol. We conclude that both dilevalol and metoprolol are equally effective in lowering BP. Dilevalol appears to have a more favorable safety profile than metoprolol.",
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AU - Glasser, S.

AU - Ramanathan, K

AU - Ahmad, S.

AU - Moreledge, J. H.

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