Skip to main content
SpringerLink
Log in

Comparison of casual, ambulatory and self-measured blood pressure in a study of nitrendipine vs bisoprolol

  • Originals
  • Published:
European Journal of Clinical Pharmacology Aims and scope Submit manuscript

Summary

In a double-blind, placebo-controlled study the antihypertensive efficacy and tolerability of a single morning dose of either 10 mg bisoprolol (n=26) or 20 mg nitrendipine (n=27) were investigated. Blood pressure was measured by three techniques: (1) Casual blood pressure 24 h after the dose; (2) ambulatory 24-h whole-day monitoring; and (3) self-recorded blood pressure in the morning 24 h after the dose (6–8 a.m.) and in the evening (6–8 p.m.). After 4 weeks of therapy bisoprolol had produced a highly significant reduction in blood pressure as assessed by casual, ambulatory day- and night-time monitoring, and self-measured morning and evening readings. Bisoprolol was significantly more effective than nitrendipine, which did not induce a significant reduction in the ambulatory night-time recordings. Whole-day ambulatory blood pressure profiles showed an antihypertensive effect of bisoprolol throughout the entire 24-h period. 24-h blood pressure curves after nitrendipine demonstrated a markedly shorter duration of action, with no reduction in early morning blood pressure. Adverse effects and tolerability of the two drugs were comparable. The average changes in systolic and diastolic blood pressure after bisoprolol and nitrendipine in 2-h periods of ambulatory monitoring (6–8 a.m. and 6–8 p.m.) and self-measured blood pressure (6–8 a.m. and 6–8 p.m.) showed a good agreement between ambulatory and self-measured blood pressure determinations with no significant difference between the methods.

The results show that 24 h antihypertensive efficacy was more pronounced for bisoprolol than for nitrendipine at the doses studied. Further, self-measured blood pressures at home were suitable for accurate estimation of the 12-h and 24-h antihypertensive efficacy of the two drugs. The methodological findings of this study have important implications for further pharmacological trials investigating the duration of action of antihypertensive drugs.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Meyers A, Dewar HA (1975) Circumstances attending 100 deaths from coronary artery disease with coroners' necropsies. Br Heart J 37: 1133–1143

    Google Scholar 

  2. Muller JE, Ludmer PL, Willich SN, et al. (1987) Circadian variation in the frequency of sudden death. Circulation 75: 131–138

    Google Scholar 

  3. Agnoli A, Manfredi M, Mossuto L, Picinelli A (1975) Relationship between circadian rhythms and blood pressure and the pathogenesis of cerebrovascular insufficiency. Rev Neurol 131: 597–606

    Google Scholar 

  4. Neutel JM, Schnaper H, Cheung DG, Graettinger WF, Weber MA (1990) Antihypertensive efficacy of β-blockers administered once daily: 24-hour measurements. Am Heart J 120: 166–171

    Google Scholar 

  5. White BW (1989) Methods of blood pressure determination to assess antihypertensive agents: Are casual measurements enough? Clin Pharmacol Ther 45 Nr.6: 581–586

    Google Scholar 

  6. Mengden T, Schubert M, Jeck T, Edmonds D, Vetter W (1990) Casual versus ambulatory twenty-four-hour blood pressure measurement in a comparative study with bisoprolol or nitrendipine. J Hypertension [Suppl 4]: S91–S94

  7. Waeber B, Petrillo A, Scherrer U, et al. (1987) Are some hypertensive patients overtreated. A prospective study on ambulatory blood pressure recording. Lancet II: 732–734

    Google Scholar 

  8. Weber MA, Cheung DG, Graettinger WF, Lipson JL (1988) Characterization of antihypertensive therapy by whole-day blood pressure monitoring. JAMA 259: 3281–3285

    Google Scholar 

  9. Menard J, Serrurier D, Bautier P, Plouin PF, Corvol P (1988) Crossover design to test antihypertensive drugs with self-recorded blood pressure. Hypertension 11: 153–159

    Google Scholar 

  10. Cottier C, Julius S, Gajendragadkar SV, Shork A (1982) Usefulness of home blood pressure determination in treating borderline hypertension. JAMA 248: 555–558

    Google Scholar 

  11. Gould BA, Hornung RS, Kieso H, Cashman PMM, Raftery ER (1986) An evaluation of self-recorded blood pressure during drug trials. Hypertension 8: 267–271

    Google Scholar 

  12. Joint National Committee on Detection, Evaluation and Treatment of High Blood Pressure (1988) The 1988 report of the Joint National Committee on Detection, Evaluation and Treatment of High Blood Pressure. Arch Intern Med 148: 1023–1038

    Google Scholar 

  13. Hansson L (1983) Pharmacokinetic and pharmacodynamic parameters in patients treated with nitrendipine. Hypertension 5 [Suppl II]: 25–28

    Google Scholar 

  14. Rüddel H, Schmieder R, Langewitz W, Neus J, Wagner O (1984) Efficacy of nitrendipine as baseline antihypertensive therapy. J Cardiovasc Pharmacol 6 [Suppl 7]: 1049–1052

    Google Scholar 

  15. Lancaster SG, Sorkin EM (1988) Bisoprolol. A preliminary review of its pharmacodynamic and pharmacokinetic properties, and therapeutic efficacy in hypertension and angina pectoris. Drugs 36: 256–285

    Google Scholar 

  16. Lithell H, Selinus J, Hosie J, Frithz G, Weiner L (1987) Efficacy and safety of bisoprolol and atenolol in patients with mild to moderate hypertension: a double-blind, paralell group inter-national multicentre study. Eur Heart J 8 [Suppl M]: 55–64

    Google Scholar 

  17. Kirkendall WM, Feinlieb M, Freis ED, Mark AL (1980) Recommendation for human blood pressure determinations by sphygmomamometers. Circulation 62: 1146A-1155A

    Google Scholar 

  18. O'Brien E, Sheridan J, Browne T, Conroy R, O'Malley K (1989) An evaluation of the Spacelabs 90202 non-invasive ambulatory blood pressure recorder. J Hypertension 7 [Suppl 6]: S388-S389

    Google Scholar 

  19. Graettinger WF, Lipson JL, Cheung DJ (1988) Validation of oscillometric, auscultatory and r-wave gated auscultatory automated portable blood pressure measurements by intra-arterial line and sphygmomanometer. Am Heart J 116: 1155–1160

    Google Scholar 

  20. Zeerssen D, Strian F, Schwarz D (1974) Evaluation of depressive states, especially in longitudinal studies. In: Pichot P, Olivier-Martin R (eds) Psychological measurements in psychopharmacology. Modern problems in pharmacopsychiatry. Basel 7: 189–202

    Google Scholar 

  21. Goa KL (1987) Nitrendipine. A review of its pharmacodynamic and pharmacokinetic properties, and therapeutic efficacy in the treatment of hypertension. Drugs 33: 123–155

    Google Scholar 

  22. Weiner L, Fritz G (1986) Antihypertensive effect of bisoprolol during once daily administration in patients with essential hypertension. A dose-ranging study with paralell groups. Eur J Clin Pharmacol 29: 517–521

    Google Scholar 

  23. Heagerty AM, Swales JD (1989) A double-blind randomised cross-over study of the efficacy and tolerability of nifedipine and nitrendipine in the treatment of mild to moderate hypertension. Br J Clin Pharmacol 27: 411–416

    Google Scholar 

  24. Steiner A, Oertel R, Bättig B, Pletscher W, Weiss B, Greminger P, Vetter W (1989) Effect of fish oil on blood pressure and serum lipids in hypertension and hyperlipidaemia. J Hypertension 7 [Suppl 3]: 73–76

    Google Scholar 

  25. Meyer-Sabellek W, Schulte KL, Streitberg B, Gotzen R, Distler (1988) A. 24-hour noninvasive blood pressure monitoring: evaluation of the antihypertensive circadian profile of nitrendipine. J Cardiovasc Pharmacol 12 [Suppl 4]: 22–28

    Google Scholar 

  26. Lazarus JH, Littley MD, Philips DIW (1988) Efficacy of once daily nitrendipine in essential hypertension — a study using ambulatory blood pressure monitoring. J Hum Hypertens 2: 191–194

    Google Scholar 

  27. Groth H, Stimpel M, Edmonds D, Mosca R, Vetter W (1985) Nitrendipine, a new calcium antagonist, as first-choice treatment in essential hypertension. Schweiz Rundschau Med (Praxis) 74: 503–506

    Google Scholar 

  28. Wortmann A, Schmidt M, Bachmann K (1987) Antihypertensive action of nitrendipine once daily. Schweiz Rundschau Med (Praxis) 76: 469–472

    Google Scholar 

  29. Maisch B, Borst U, Gerhards W, Wagner G (1989) Effect of bisoprolol on cardiac performance in coronary heart disease. Eur J Clin Pharmacol 36: 217–222

    Google Scholar 

  30. Ménard J, Bellet M, Serrurier D (1990) From the parallel group design to the crossover design, and from the group approach to the individual approach. Am J Hypertens 3: 815–819

    Google Scholar 

  31. Moser M, Lunn J, Nash DT, Burris JF, Winer N (1984) Nitrendipine in the treatment of mild to moderate hypertension. J Cardiovasc Pharmacol 6 [Suppl 7]: 1085–1089

    Google Scholar 

  32. Fagan TC, Sternleib C, Vlachakis N, Deedwania PC, Dehta JL (1984) Efficacy and safety comparison of nitrendipine and hydralazine as antihypertensive monotherapy. J Cardiovasc Pharmacol 6 [Suppl 7]: 1109–1113

    Google Scholar 

  33. Haasis R, Bethge H (1987) Exercise blood pressure and heart rate reduction 24 and 3 hours after administration in hypertensive patients following 4 weeks treatment with bisoprolol and metoprolol: a randomised, multicentre double-blind study (BISOMET). Eur Heart J 8 [Suppl M]: 103–113

    Google Scholar 

  34. Honore P (1987) Bisoprolol vs hydrochlorothiazide plus amiloride in essential hypertension, a randomised double blind study. Eur Heart J 8 [Suppl M]: 95–102

    Google Scholar 

  35. Edmonds D, Knorr M, Greminger P, et al. (1987) ACE-inhibitor versus beta-blocker in the treatment of essential hypertension. Nephron 47 [Suppl 1]: 90–93

    Google Scholar 

  36. Dimenas ES, Dahlof CG, Lindvall KG, Olofson BK, De Faire UH (1989) Differences in the subjective well-being and symptoms in normotensives, borderline-hypertensives and hypertensives. J Hypertension 7 [Suppl 11]: 885–890

    Google Scholar 

  37. Irvine MJ, Garner DM, Olmsted MP, Logan AG (1989) Personality differences between hypertensive and normotensive individuals: Influence of knowledge of hypertensive status. Psychosom Med 51: 537–549

    Google Scholar 

  38. Wezel D, Bräutigam M (1988) Quality of life as a dimension in drug development. Curr Opin Cardiol 3 [Suppl 2]: 59–64

    Google Scholar 

  39. Croog SH, Levine S, Testa MA, Brown B, Bulpitt CJ, Jenkins CD, Klerman GL, Williams GH (1986) The effects of antihypertensive therapy on the quality of life. N Engl J Med 314: 1657–1664

    Google Scholar 

  40. Blumenthal JA, Ekelund L-G, Emery CF (1990) Quality of life among hypertensive patients with a diuretic background who are taking atenolol and enalapril. Clin Pharmacol Ther 48: 447–454

    Google Scholar 

  41. Steiner SS, Friedhoff AJ, Wilson BL, Wecker JR, Santo JP (1990) Antihypertensive therapy and quality of life: a comparison of atenolol, captopril, enalapril and propanolol. J Hum Hypertension 4 [Suppl 3]: 217–225

    Google Scholar 

  42. Fletcher AE, Bulpitt CJ, Hawkins CM, Havinga TK, ten-Berge BS, May JF, Schuurman FH, van-der-Veur E, Wesseling H (1990) Quality of life on antihypertensive therapy: a randomized double-blind controlled trial of captopril and atenolol. J Hypertension 8 [Suppl 5]: 463–466

    Google Scholar 

  43. Weisser B, Mengden T, Vetter W (1991) Ambulatory twenty-four-hour blood pressure measurement in pharmacological studies. J Hypertension 8 [Suppl 6]: 87–92

    Google Scholar 

  44. Brown GE (1930) Daily and monthly rhythm in the blood pressure of a man with hypertension. Ann Intern Med 3: 1177–1189

    Google Scholar 

  45. Ayman D, Goldshine AD (1940) Blood pressure determinations by patients with essential hypertension. Am J Med Sci 200: 465–473

    Google Scholar 

  46. Mengden T, Bättig B, Edmonds D, Jeck T, Huss R, Sachinidis A, Schubert M, Feltkamp H, Vetter W (1990) Self-measured blood pressures at home and during consulting hours: are there any differences? J Hypertension 8 [Suppl 3]: 15–19

    Google Scholar 

  47. Kleinert HD, Harshfield GA, Laragh JH (1984) What is the value of home blood pressure measurement in patients with mild hypertension? Hypertension 6: 574–578

    Google Scholar 

  48. Mengden T, Bättig B, Vetter W (1991) Self-measurement of blood pressure improves the accuracy and reduces the number of subjects in clinical trials. J Hypertension 9 [Suppl 6]: 336–337

    Google Scholar 

  49. Weber Ma, Tonkon MJ, Klein RG (1987) Blood pressure monitoring for assessing the duration of action of antihypertensive treatment. J Clin Pharmacol 27: 751–755

    Google Scholar 

  50. Gordon RD, Pawskey GK, O'Halloran MW, Abbot ML, Wilson LL, Silverstone H (1971) Use of home blood pressure measurement to compare the efficay of two diuretics. Med J Austr 2: 565–570

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Internal Medicine and Department of Psychiatry, University Hospital, Zurich, Switzerland

    T. Mengden, B. Bättig, M. Schubert, T. Jeck, B. Weisser, C. Buddeberg & W. Vetter

Authors
  1. T. Mengden
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. B. Bättig
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. M. Schubert
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. T. Jeck
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. B. Weisser
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. C. Buddeberg
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. W. Vetter
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Mengden, T., Bättig, B., Schubert, M. et al. Comparison of casual, ambulatory and self-measured blood pressure in a study of nitrendipine vs bisoprolol. Eur J Clin Pharmacol 42, 569–575 (1992). https://doi.org/10.1007/BF00265917

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF00265917

Key words

Search

Navigation