The treatment of hypertension in older patients: a double-blind, between-patient study, in previously treated patients comparing a diuretic, a beta-receptor antagonist, and their fixed combination.

Six hundred and forty-eight previously treated hypertensive patients, with a mean age of 64 years, were studied. In spite of treatment over a mean period of 18 months, their blood pressure was inadequately controlled, with an initial mean level of 180/108 mm Hg. Previous treatment which had consisted of either a diuretic alone, a beta-receptor antagonist alone or these two drugs in combination was discontinued and patients were randomly allocated, in double-blind manner, to a 6-week treatment course of cyclopenthiazide (Navidrex) or sustained release oxprenolol (Slow-Trasicor) or a fixed combination of these two compounds (Trasidrex) with the aim of lowering the diastolic pressure to less than 100 mm Hg. Blood pressure was substantially reduced in each treatment group, with the lowest final pressures in the group treated with the fixed combination, where 87% of the patients completing the study reached the target level of a diastolic pressure of less than 100 mm Hg. Very few side-effects of treatment were reported with any of these compounds. The results from this study suggest that these compounds in their standard dosage range are useful and safe antihypertensive agents in older patients. In those patients where blood pressure control with a single agent was proving difficult, the transfer to one or two tablets daily of the fixed combination (Trasidrex) produced a very satisfactory outcome in the large majority of cases.

Use of a sustained-release formulation of oxprenolol and cyclopenthiazide ('Trasidrex') in the management of hypertension: a general practice study.

An open study was carried out in general practice on 678 hypertensive patients being treated with a beta-blocker but who still had resting diastolic blood pressures greater than 100 mmHg. Previous treatment was stopped and substituted with 1 or 2 tablets daily of a fixed combination product containing 160 mg oxprenolol hydrochloride in a sustained-release formulation plus 0.25 mg cyclopenthiazide per tablet. After 4-weeks' treatment on this regimen, blood pressure levels fell significantly, from 179/108 mmHg to 155/93 mmHg, without any increase in the reporting of unpleasant side-effects.

An open comparison between free and a fixed combination of diuretic and beta-blocker in the management of essential hypertension.

A total of 1,117 patients with inadequately controlled hypertension in spite of treatment with a combination of diuretic and beta-adrenergic blocker were studied. Treatment was changed to one or two tablets daily of Trasidrex (160 mg oxprenolol hydrochloride in a sustained release formulation and 0.25 mg cyclopenthiazide) with a subsequent improvement, 4 weeks later, in blood pressure control. Side-effects of treatment were uncommon and treatment was approved by the majority of patients. The majority of doctors participating thought a fixed combination would improve patient compliance with therapy.

Experience with a sustained-release formulation of oxprenolol in the management of angina pectoris in hospital out-patient departments.

One hundred and two patients with angina pectoris under treatment with beta-receptor antagonists prescribed on a multi-dose basis were openly switched to treatment with once-daily sustained-release oxprenolol (160 mg per tablet). Eighty-eight patients were successfully managed on once-daily oxprenolol and 70% achieved significant benefit with a single morning dose of 160 mg. The mean number of anginal attacks and the mean glyceryl trinitrate consumption were both significantly reduced. It is concluded that once-daily treatment with oxprenolol in sustained-release form offers the advantage of reduced tablet ingestion without symptomatic detriment in the management of angina pectoris.

A multicentre evaluation of sustained release oxprenolol in the management of hypertension in hospital out-patient practice.

One hundred and two patients with essential hypertension, managed in hospital out-patient clinics in the United Kingdom on a drug regime of beta-receptor antagonist alone, or in combination with a diuretic were successfully transferred to once daily sustained release oxprenolol. Where a diuretic was prescribed the dose remained unchanged. Improved control of blood pressure was recorded in the majority of patients with one or two morning tablets of sustained release oxprenolol. Preference for once daily therapy, enthusiasm for the calendar pack, and a net increase in the mean daily dosage of a beta-receptor antagonist were the probable factors contributing to the improvement recorded. Once daily sustained release oxprenolol would appear, in most hypertensive patients, to be an effective substitute for multi-dose treatment with beta-receptor antagonists in conventional formulation.

Maprotiline (Ludiomil) in depression: a report of a monitored release study of 10,000 patients in general practice.

In a three-week study of 10,000 general practice patients with depressive illness, a single dose of maprotiline 75 mg at night was effective therapy in three-quarters of the patients who completed the study. At this dose the drug was well tolerated, and troublesome side-effects presented in only a small percentage of patients. Drowsiness was the most commonly reported side-effect, and the main reason for withdrawal of treatment. The drug was acceptable to most physicians, and in this study was used in a wide range of patients and over a broad spectrum of depressive illness.

Maprotiline (Ludiomil) in depression: a report of a monitored release study in general practice.

In a three-week study of 10,000 general practice patients with depressive illness, a once nightly dose of maprotiline 75 mg (Ludiomil) was effective therapy in three-quarters of the patients who completed the study. At this dose the drug was well tolerated, and troublesome side-effects presented in only a small percentage of patients. Drowsiness was the most commonly reported side-effect, and the main reason for stopping treatment. The drug was acceptable to most physicians, and in this study was used in a wide age range of patients and over a broad spectrum of depressive illness.

Maprotiline (Ludiomil) in depression: a multicentre assessment of onset of action, efficacy and tolerability.

Although open studies have a built-in bias of optimism the results from this study, made valid by the large numbers of patients involved, support the findings reported with smaller numbers in controlled series of studies showing an early onset of action with maprotiline (Ludiomil). The method used in this study to detect unwanted effects indicates that maprotiline is well tolerated. In summary, the efficacy of once daily dosage, the good response in differing types of depressive illness, the early onset of effectiveness without serious side-effects in a wide age range of patients suggests that this drug will be a useful addition for the treatment of depressive illness in general practice.

Oxprenolol in hypertension: a report on 2,770 patients in general practice originally treated with methyldopa.

Substitution, in part of totally, of the non-selective beta-receptor antagonist oxprenolol for methyldopa in 2,770 treated hypertensive patients resulted in a significant reduction in blood pressure levels and a considerable improvement in the quality of the patient's life.