Skip to main content
SpringerLink
Log in

A comparison of the effects of the selective peripheralα 1-blocker terazosin with the selectiveβ 1-blocker atenolol on blood pressure, exercise performance and the lipid profile in mild-to-moderate essential hypertension

  • Research Paper
  • Published:
Clinical Autonomic Research Aims and scope Submit manuscript

Abstract

The effects of six weeks of treatment with the selective peripheralα 1-adrenoceptor blocker terazosin, or the selectiveβ 1-adrenoceptor blocker atenolol on blood pressure, exercise performance and blood lipid profile were compared in a single-blind, randomized, crossover study of 17 patients with mild-to-moderate essential hypertension. Although both drugs significantly reduced blood pressure at rest, atenolol caused a larger fall in supine blood pressure (11/11 and 7.5/7.0 mmHg, atenolol and terazosin, respectively;p < 0.001). Both treatments controlled the pressor response to exercise, although a greater reduction in diastolic blood pressure was observed at the end of exercise on terazosin (74.0 ± 5.7 and 91.6 ± 4.0 mmHg, terazosin and atenolol, respectively;p < 0.01). Alpha1-blocker therapy was not associated with any measurable improvement or deterioration in cardiopulmonary performance and exercise duration. Unlike atenolol, terazosin therapy had the potentially beneficial effect of reducing serum total cholesterol levels and increasing the high-density lipoprotein-cholesterol/low-density lipoprotein-cholesterol ratio.

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. Ames RP. Metabolic disturbances in increasing the risk of coronary heart disease during diuretic-based antihypertensive therapy: lipid alterations and glucose intolerance.Am Heart J 1983;106: 1207–1214.

    PubMed  Google Scholar 

  2. Lehtonen A, Marniemi J. Effect of atenolol on plasma HDL cholesterol subfractions.Atherosclerosis 1984;51: 335–338.

    PubMed  Google Scholar 

  3. Jennings G, Nelson L, Nestel P. The effects of changes in physical activity on major cardiovascular risk factors, haemodynamics, sympathetic function and glucose utilization in man: a controlled study of 4 levels of activity.Circulation 1986;73: 30.

    PubMed  Google Scholar 

  4. Nelson L, Jennings GL, Esler MD, Korner PI. The effect of changing levels of physical activity on blood pressure and haemodynamics in patients with essential hypertension.Lancet 1986;ii: 473.

    Google Scholar 

  5. World Hypertension League. Physical exercise in the management of hypertension: a consensus statement by the World Hypertension League.J Hypertension 1991;9: 283–287.

    Google Scholar 

  6. Powell KE, Thompson PD, Caspersen CJ, Kendrick JS. Physical activity and the incidence of coronary heart disease.Ann Rev Public Health 1987;8: 253–287.

    Google Scholar 

  7. Lund-Johansen P. Exercise and antihypertensive therapy.Am J Cardiol 1987;59: 98A-107A.

    PubMed  Google Scholar 

  8. Ades PA, Gunther PGS, Meacham CP, Handy MA, Lewinter MM. Hypertension, exercise and beta-adrenergic blockade.Ann Intern Med 1988;109: 629–634.

    PubMed  Google Scholar 

  9. Humphreys JE, Waite MA. Alpha 1-blockers. A new generation of antihypertensive agents.J Clin Pharmacol Ther 1989;14: 263–283.

    Google Scholar 

  10. Smithet al. Racial differences in the incidence and progression of renal disease.Kidney Int 1991;40: 815–822.

    PubMed  Google Scholar 

  11. Hills M, Armitage P. The two-period cross-over clinical trial.Br J Clin Pharmac 1979;8: 7–20.

    Google Scholar 

  12. de Backer G, Rosseneu M, Deslypere JP. Discriminative value of lipids and apolipoproteins in coronary artery disease.Atherosclerosis 1982;42: 197–203.

    PubMed  Google Scholar 

  13. Pollare T, Lithell H, Berne C. Application of prazosin is associated with an increase of insulin sensitivity in obese patients with hypertension.Diabetologia 1988;31: 415–420.

    PubMed  Google Scholar 

  14. Leenen FHH, Smith DL, Farkas RM, Reeves RA, Marquez JA. Vasodilators and regression of left ventricular hypertrophy: hydralazine versus prazosin in hypertensive humans.Am J Med 1987;82: 969–978.

    PubMed  Google Scholar 

  15. Titmarsh S, Monk JP. Terazosin: a review of its pharmacodynamic and pharmacokinetic properties, and therapeutic efficacy in essential hypertension.Drugs 1987;33: 461–477.

    PubMed  Google Scholar 

  16. Luther RR, Glassman HN, Estep CB, Maurath CJ, Jordan DC. The effect of terazosin and methyclothiazide on blood pressure and serum lipids.Am Heart J 1989;117: 842–847.

    PubMed  Google Scholar 

  17. Sperzel WD, Glassman HN, Jordan DC, Luther RR. Overall safety of terazosin as an antihypertensive agent.Am J Med 1986;80 (suppl 5B): 77–81.

    Google Scholar 

  18. Deger G, Cutler RE, Dietz AJ, Lewin AJ, Veachakis N. Comparison of the safety and efficacy of once daily terazosin versus twice daily prazosin for the treatment of mild to moderate hypertension.Am J Med 1986;80 (suppl 5B): 62–67.

    Google Scholar 

  19. Ruoff G, Cohen A, Hollifield JW, McCarron DA. Comparative trials of terazosin with other antihypertensive agents.Am J Med 1986;80 (suppl 5B): 42–48.

    PubMed  Google Scholar 

  20. Conway J. Haemodynamic aspects of essential hypertension in humans.Physiol Rev 1984;64: 617–660.

    PubMed  Google Scholar 

  21. Lund-Johansen P, Omvik P, Haugland H. Acute and chronic haemodynamic effects of doxazosin in hypertension at rest and during exercise.Br J Clin Pharmacol 1986;21: 455–545.

    Google Scholar 

  22. Lund-Johansen P. Central haemodynamic effects of beta-blockers in hypertension. A comparison between atenolol, metoprolol, timolol, penbutolol, alprenolol, pindolol and bumitrolol.Eur Heart J 1983;4 (suppl D): 1–12.

    Google Scholar 

  23. Bennett T, Wilcox RG, MacDonald IA. Post-exercise reduction of blood pressure in hypertensive men is not due to acute impairment of baroreflex function.Clin Sci 1984;67: 97–103.

    PubMed  Google Scholar 

  24. Wilcox RG, Bennett T, MacDonald IA, Broughton Pipkin F, Baylis PH. Post-exercise hypotension: the effects of epanolol or atenolol on some hormonal and cardiovascular variables in hypertensive men.Br J Clin Pharmacol 1987;24: 151–162.

    PubMed  Google Scholar 

  25. Tipton CM. Exercise training and hypertension.Exerc Sport Sci Rev 1984;12: 245–306.

    PubMed  Google Scholar 

  26. Dowell RT. Cardiac adaptations to exercise.Exerc Sport Sci Rev 1984;12: 208–244.

    Google Scholar 

  27. Wood PD, Haskell WL. The effect of exercise on plasma high density lipoproteins.Lipids 1979;14: 417–427.

    PubMed  Google Scholar 

  28. Ruys T, Shaikh M, Nordestgaard G, Sturgess I, Watts GF, Lewis B. Effect of exercise and fat ingestion on high density lipoprotein production by peripheral tissues.Lancet 1989;ii: 1119–1122.

    Google Scholar 

  29. Epstein SE, Robinson BF, Kahler RL, Braunwald E. Effects of beta-adrenergic blockade on the cardiac response to maximal and submaximal exercise in man.J Clin Invest 1965;44: 1745–1753.

    PubMed  Google Scholar 

  30. Eklund B, Kaijser L. Effect of regional alpha- and beta-blockade on blood flow in the resting forearm during contralateral isometric handgrip.J Physiol (Lond) 1976;262: 39–50.

    Google Scholar 

  31. Chasiotis D, Brandt R, Harris RC, Hultman E. The effects of beta-blockade on glycogen metabolism in human subjects during exercise.Am J Physiol 1983;245: E166-E170.

    PubMed  Google Scholar 

  32. Savin WM, Gordon EP, Kaplan SM, Hewitt BF, Harrison DC, Haskell WL. Exercise training during long-term beta-blockade treatment in healthy subjects.Am J Cardiol 1985;55: 101D-109D.

    PubMed  Google Scholar 

  33. McLeon AA, Kraus WE, Williams RE. Effects of beta, selective and nonselective beta-adrenoceptor blockade during exercise conditioning in healthy adults.Am J Cardiol 1984;53: 1656–1661.

    PubMed  Google Scholar 

  34. Wilcox RG, Bennett T, MacDonald IA, Herbert M, Skene AM. The effects of acute or chronic ingestion of propranolol or metoprolol on the physiological responses to prolonged, submaximal exercise in hypertensive men.Br J Clin Pharmacol 1984;17: 273–281.

    PubMed  Google Scholar 

  35. Patrick JM, Tutty J, Pearson SB. Propranolol and the ventilatory response to hypoxia and hypercapnia in normal man.Clin Sci Molec Med 1978;55: 491–497.

    Google Scholar 

  36. Vanhees L, Fagard R, Lijnen P, Amery A. Effect of antihypertensive medication on endurance exercise capacity in hypertensive sportsmen.J Hypertension 1991;9: 1063–1068.

    Google Scholar 

  37. Gillin AG, Fletcher PJ, Horvath JS, Hutton BF, Bautovich GJ, Tiler DJ. Comparison of Doxazosin and Atenolol in mild hypertension, and effects on exercise capacity, hemodynamics and left ventricular function.Am J Cardiol 1989;63: 950–954.

    PubMed  Google Scholar 

  38. Nellis SH, Flaim SF, McCauley KM, Zelis R. Alpha-Stimulation protects exercise increment in skeletal muscle oxygen consumption.Am J Physiol 1980;238: H331-H339.

    PubMed  Google Scholar 

  39. Cleland JGF, Oakley CM. Vascular tone in heart failure: the neuroendocrine—therapeutic interface.Br Heart J 1991;66: 264–267.

    PubMed  Google Scholar 

  40. Rosenthal J. Blood pressure and lipid lowering effects of terazosin.J Human Hypertension 1989;3 (suppl 2): 85–91.

    Google Scholar 

  41. Deger G. Effects of terazosin on serum lipids.Am J Med 1986;80 (suppl 5B): 82–85.

    Google Scholar 

  42. Frick MH, Cox DA, Himanen P,et al. Serum lipid changes in a one-year, multicenter double-blind comparison of doxazosin and atenolol for mild to moderate essential hypertension.Am J Cardiol 1987;59: 61G-67G.

    PubMed  Google Scholar 

  43. Pool JL. Effects of doxazosin on serum lipids: a review of the clinical data and molecular basis for altered lipid metabolism.Am Heart J 1991;121: 251–260.

    PubMed  Google Scholar 

Download references

Author information

Author notes

  1. M. Ligueros

    Present address: Departamento de Farmacologia, Facultad de Medicina, Div. Norte, Universidad de Chile, Av. Independencia 1027, 70.000-7, Santiago, Casilla, Chile

  2. R. Unwin

    Present address: Department of Nephrology, Institute Urology & Nephrology, Middlesex Hospital, Mortimer Street, W1N 8AA, London, UK

Authors and Affiliations

  1. Department of Medicine (Cardiology), Royal Postgraduate Medical School, Hammersmith Hospital, Ducane Road, W12 ONN, London, UK

    M. R. Wilkins & J. Cleland

  2. Abbott Laboratories, Maidenhead, UK

    J. Humphreys & S. J. Coles

Authors
  1. M. Ligueros
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. R. Unwin
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. M. R. Wilkins
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. J. Humphreys
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. S. J. Coles
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. J. Cleland
    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

Ligueros, M., Unwin, R., Wilkins, M.R. et al. A comparison of the effects of the selective peripheralα 1-blocker terazosin with the selectiveβ 1-blocker atenolol on blood pressure, exercise performance and the lipid profile in mild-to-moderate essential hypertension. Clinical Autonomic Research 2, 373–381 (1992). https://doi.org/10.1007/BF01831394

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01831394

Key words

Search

Navigation