[Long-term therapy with beta receptor blockaders].

Abstract

It is difficult for the physician to choose the therapeutic method and the remedy when a plethora is caused by antihypertensive drugs. Apart from the efficacy in the planning of a life-long treatment the compatibility and the simplicity shall increasingly be taken into consideration, for only thus the best possible therapy discipline is to be achieved. Three components--beta-blockers, diuretic and vasodilator--were systematically--alone and combined--applied. Of 188 patients 44% reacted on a beta-blocker alone, 22% on a diuretic alone, other 15% on the combination of the two as well as further 10% only on the triple combination with an addition of vasodilators. The beta-blocker-monotherapy was more successful in younger patients, frequently with high renin content, and in patients up to 60 years. In older patients, more frequently with low renin content, a diuretic or addition of vasodilators was necessary. The blood pressure before the treatment was, however, not decisive for the success of the therapy. In the remaining 9% the beta-blocker was either contraindicated, or even the triple combination did not decrease the diastolic pressure below the desirable aim of 95 Torr. A scheme of therapy, which is based on a beta-blocker, may besides be further simplified by long-acting substances allowing a single daily dosage. This fact is confirmed in a double comparison of Atenolol and Oxprenolol (slow release) in 13 patients. Apart from the favourable relation of effect and compatibility of the beta-blockers these substances antagonize disadvantageous effects of the diuretics and vasodilators. Moreover, they promise a protection of the heart also in the patient with hypertension, which could not be proved with the antihypertensive therapy performed up to now.