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      The Effects of Tertatolol on Lipid Profile

      , ,

      Cardiology

      S. Karger AG

      Hypertension, Lipids, Peripheral arterial disease, Tertatolol

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          Abstract

          Tertatolol is a noncardioselective beta-blocker without intrinsic sympathomimetic activity. In a preliminary 3-month open study, it was shown that T was devoid of any atherogenic effect since HDL-cholesterol (HDL-C) and apoprotein levels did not change for 3 months of therapy. To investigate the long-term effects of tertatolol on the lipid profile and its safety in hypertensive patients with peripheral arterial disease (PAD), a 9-month, randomized, double-blind, parallel group study was carried out in 40 patients. Tertatolol 5 mg once daily was compared with metoprolol 200 mg once daily. If BP was not controlled after 2 months, a vasodilatator agent, dihydralazine, was added at the lowest dose required to control BP (diastolic BP < 90 mm Hg). Lipoprotein fractions and apoproteins were assayed before (MO) and after 2, 6 and 9 months of therapy. At the same occasions, peripheral arterial disease (PAD) was evaluated on exercise tests carried out on a treadmill and on the regional blood flow measured in the ankle arteries by the Doppler technique. Four patients were not eligible for analysis. In the tertatolol group, 1 patient with a normal BP, and 2 patients who dropped out, 1 because of persistent nausea and 1 because of personal reasons. In the metoprolol group, 1 patient refused to take dihydralazine. In the 35 fully documented patients, BP control was achieved in both groups. The mean reductions in supine systolic/diastolic BP were 31.4/14.6 and 34.7/17.1 mm Hg in the tertatolol and metoprolol groups, respectively. Throughout the 9 months, no significant difference between groups was observed in the change of lipid parameters, except for the apoprotein A2 level which increased significantly with tertatolol (+24 vs. +3% with metoprolol, p = 0.043). Changes in lipid profile were less marked with tertatolol than with metoprolol: triglycerides increased by 2 and by 13% with tertatolol and metoprolol, respectively. HDL-cholesterol decreased by 11 % with metoprolol and increased by 2% with tertatolol. Total and LDL·cholesterol remained stable with both drugs. The apo Al/apo B ratio, which inversely correlates with the atherogenic risk, decreased by 7 and 25% with tertatolol and metoprolol, respectively. Peripheral arterial disease improved with both drugs: pain-free walking distance increased by 33.0 and 51.6 m with metoprolol and tertatolol, respectively. Residual pressure index remained unchanged with both drugs since the calf BP measured in the ankle arteries decreased in proportion to the decrease in brachial BP. Thus, both drugs were effective and well-tolerated since they controlled BP and improved the intermittent claudication. Considering its beneficial effects on the lipid parameters, tertatolol could be a better choice than metoprolol in the treatment of hypertensive patients with severe PAD.

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          Author and article information

          Journal
          CRD
          Cardiology
          10.1159/issn.0008-6312
          Cardiology
          S. Karger AG
          978-3-8055-5869-3
          978-3-318-01965-0
          0008-6312
          1421-9751
          1993
          1993
          18 November 2008
          : 83
          : Suppl 1
          : 32-40
          Affiliations
          Medizinische Klinik im Rehabilitationskrankenhaus Karlsbad, BRD
          Article
          176008 Cardiology 1993;83:32–40
          10.1159/000176008
          7903213
          © 1993 S. Karger AG, Basel

          Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

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          Pages: 9
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