Bopindolol: Czechoslovak experience with a new beta blocker in the treatment of hypertension

Hypertension, or high blood pressure, is often treated with drugs known as adrenergic beta blocking agents, or beta blockers. These drugs have been found to be quite effective in lowering blood pressure over the long term; between 40 and 50 percent of patients experience a normalization of blood pressure levels. The drugs do not produce postural hypotension (excessively low blood pressure when the patient stands), and most beta blockers have a relatively low rate of unacceptable side effects. However, beta blockers have been less effective than had been hoped in reducing overall cardiovascular disease and death. This most likely results from the adverse effects that many beta blockers have on lipid and carbohydrate metabolism; decreases in insulin sensitivity, high blood sugar levels, increased blood lipid (fat) levels, and decreases in high-density lipoprotein cholesterol (so-called ''good'' cholesterol) have been reported. This adverse metabolic side effect profile appears to be lacking in some beta blockers with intrinsic sympathomimetic activity (ISA; weak excitatory activity at the receptors they bind to). Bopindolol, a potent beta blocker with a prolonged duration of action and moderate ISA, has been used in some cases in the treatment of hypertension. To further characterize the effects of this drug on blood pressure and metabolism, several studies were carried out at two Czechoslovakian medical centers. The drug was found to be effective for 24 hours in reducing blood pressure in hypertensive patients; hence, once-daily administration was sufficient. Seventy percent of the patients experienced a return to normal blood pressure values. In a separate six-month trial, bopindolol was shown to have no significant effects on total cholesterol, low-density and high-density lipoproteins, and blood triglyceride levels. No adverse effects on carbohydrate metabolism were seen. An additional 12-month study revealed an improvement in the blood triglyceride and cholesterol profiles of hypertensive patients receiving bopindolol. (Consumer Summary produced by Reliance Medical Information, Inc.)