Acute and long-term antihypertensive effect of bopindolol once daily or once weekly

Fourteen male patients, mean age 53 years (range 35-64), were included in an initial 3 months' double-blind crossover study, in which 1-2 mg bopindolol, a nonselective beta blocker with intrinsic sympathomimetic activity (ISA), was compared with 100-200 mg metoprolol regarding effects on blood pressure and heart rate. During the subsequent long-term therapy, eight patients were trained to measure home blood pressure, and in these patients bopindolol 1 mg daily was compared to 8 mg once weekly in a double-blind fashion for 3 weeks on each regimen. Bopindolol (mean dose 1.35 mg/day) caused a significant blood pressure reduction, 26/15 mm Hg, as did metoprolol, 24/3 mm Hg (mean dose 144 mg/day) (NS). Supine and standing heart rates were reduced during both bopindolol and metoprolol treatment. During long-term therapy with bopindolol satisfactory blood pressure control was achieved for 1 year in 11 patients. Heart rate was significantly reduced after 2-3 months' treatment and during the entire 1-year follow-up. Few and well-tolerated side effects were reported. During treatment with bopindolol 8 mg once weekly, the blood pressure control was maintained satisfactorily over the week and no significant differences were observed in comparison with daily administration (1 mg) of the drug.