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January 1995

The Cardiovascular, Pulmonary, and Ocular Hypotensive Effects of 0.2% Brimonidine

Author Affiliations

From The Wilmer Ophthalmological Institute (Drs Nordlund, Pasquale, and Robin), The School of Hygiene and Public Health (Dr Robin), and the Department of Medicine (Drs Rudikoff and Ordman), The Johns Hopkins University School of Medicine, Baltimore, Md, and Allergan Inc, Irvine, Calif (Ms Chen and Mr Walt).; Dr Nordlund is currently with the Department of Ophthalmology, University of Virginia, Charlottesville, and Dr Pasquale, the Division of Ophthalmology, Brigham and Women's Hospital, Boston, Mass. Drs Nordlund, Pasquale, Robin, Rudikoff, and Ordman do not have any proprietary interest in Allergan Inc, or any of the study medications.

Arch Ophthalmol. 1995;113(1):77-83. doi:10.1001/archopht.1995.01100010079024

Objective:  To compare the cardiovascular, pulmonary, and ocular hypotensive effects of 0.2% brimonidine tartrate with those of 0.5% timolol maleate, 0.25% betaxolol suspension, and brimonidine vehicle.

Design and Patients:  A single-center, double-masked, randomized, crossover study of 24 young, healthy men.

Interventions:  Baseline heart rate, blood pressure, respiratory rate, and intraocular pressure were recorded at hour 0. At hour 2, heart rate, blood pressure, respiratory rate, and forced expiratory volume in 1 second were measured and a 15-minute treadmill test performed. Hour 0 measurements were repeated at hour 4. On four subsequent visits, we instilled one drop of a study medication into each eye after the baseline measurements at hour 0.

Results:  Timolol reduced resting (−5.3 to −6.5 beats/min; P≤.004) and exercise-induced heart rate (−4.3 to −13.6 beats/min; P≤.022) compared with brimonidine, betaxolol suspension, and brimonidine vehicle. At hour 4, brimonidine reduced resting systolic blood pressure compared with all other study medications (−5.2 to −7.3 mm Hg; P≤.024). Timolol reduced systolic blood pressure during exercise and brimonidine reduced systolic blood pressure during recovery more than betaxolol suspension and brimonidine vehicle (−5.1 to −7.7 mm Hg; P≤.033; and −5.4 to −6.0 mm Hg; P≤.002, respectively). Mean respiratory rate and forced expiratory volume in 1 second were not significantly altered by any study medication. At hour 4, brimonidine lowered intraocular pressure as well as timolol and better than betaxolol suspension (−1.9 mm Hg; P<.001) or brimonidine vehicle (−1.8 mm Hg; P<.001).

Conclusions:  The cardiopulmonary effects of 0.2% brimonidine were limited to a slight reduction in systolic blood pressure during recovery from exercise and at 4 hours after instillation. The ocular hypotensive effect of brimonidine was comparable to that of timolol and greater than that of betaxolol suspension in this patient population.