Beta adrenergic blocking drugs were found to be effective hypotensive agents in the long-term treatment of patients with hypertension. In 40% of patients they appeared to be an extremely satisfactory antihypertensive agent. The fall in blood pressure was confirmed in a double blind study which also indicated that propranolol, prindolol, alprenolol and MK 950 (timolol) had similar antihypertensive properties. Propranolol and timolol reduced the pulse rate more than prindolol and alprenolol but the fall in blood pressure induced by the four drugs was not significantly different. The incidence of volunteered side effects was low, but when questioned specifically a large number of patients has disturbance of their dream pattern. This was more frequent and severe with prindolol and alprenolol. In this study bronchospasm was associated with the use of propranolol and timolol but not with that of prindolol and alprenolol.
In general, there is little difference between the various beta adrenergic blocking drugs in the treatment of hypertension, but in a few patients one or other may have advantages over the remainder. The dose ratios of the four drugs closely reflected their reported potency in producing beta adrenergic blockade. However, their exact mechanism of action is unknown, though it is probable that part of their effect is mediated via the central nervous system.
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