August 1988

Remission of Mild to Moderate Hypertension After Treatment With Carteolol, a ß-Adrenoceptor Blocker With Intrinsic Sympathomimetic Activity

Author Affiliations

From the Medical Service, Veterans Administration Medical Center and Cardiovascular Research Laboratory, Tulane University School of Medicine, New Orleans (Drs Giles, Sander, and Thomas and Ms Roffidal), the Mesaba Clinic, Hibbing, Minn (Drs Mersch and Moyer), the Cardiovascular Center of Northern Virginia, Falls Church (Drs Burris and Mroczek), and Rancocas Valley Hospital, Willingboro, NJ (Dr Brachfeld).

Arch Intern Med. 1988;148(8):1725-1728. doi:10.1001/archinte.1988.00380080029010

• Previous studies have indicated that some hypertensive patients, following a period of effective treatment with certain antihypertensive drugs, may experience prolonged normotension after drug withdrawal. We have studied the ability of carteolol, a nonselective β-adrenoceptor antagonist with intrinsic sympathomimetic activity, to produce such remissions of hypertension. Thirty-four patients whose diastolic blood pressure was controlled at 90 mm Hg or less with carteolol monotherapy (2.5 to 5.0 mg/d for an average of 328 days) were randomized to a nine-month, double-blind, placebo-controlled drug-withdrawal trial. Those patients randomized to continue carteolol therapy had initially responded to carteolol treatment with reductions in blood pressure from 151±4/99±2 to 132±4/80±2 mm Hg. Those randomized to treatment with placebo had initially responded with blood pressure reductions from 154±4/97±2 to 137±4/81±2 mm Hg. Changes in mean systolic and diastolic blood pressure (mm Hg±SEM) from baseline during carteolol therapy to the final visit at nine months were not different for patients receiving placebo (13±5/6±4 mm Hg, recumbent; 11±6/4±4 mm Hg, standing) or carteolol (11±5/7±3 mm Hg, recumbent; 12±6/7±3 mm Hg, standing). The final mean recumbent diastolic blood pressure (86.9 mm Hg) was the same in both groups. Prolonged normotension may follow a period of carteolol treatment, again suggesting the potential importance of periodic withdrawal of antihypertensive medication.

(Arch Intern Med 1988;148:1725-1728)