Comparison of effects of antihypertensive drugs on heart rate: Changes from baseline by baseline group and over time

Barry J Materson, Domenic J. Reda, David W. Williams

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Baseline heart rate is becoming recognized as a predictor of cardiovascular risk. Various antihypertensive drugs have differing effects on heart rate. A randomized controlled clinical trial of 1292 ambulatory men with stage 1 or 2 hypertension was conducted in 15 Veterans Affairs medical centers. Patients were treated with hydrochlorothiazide, atenolol, captopril, clonidine, diltiazem, prazosin, or placebo for up to 2 years. Heart rates were measured at baseline, the end of titration, 1 year, and 2 years. Data were also stratified by baseline heart rate. A subset of patients had heart rate also determined by electrocardiogram. All drugs except prazosin reduced heart rate from baseline; additional small decreases were obtained over time with hydrochlorothiazide and placebo. The decrease initially achieved with clonidine was attenuated over time. The overall reduction in heart rate was greatest for atenolol (-12.2 beats/min) and least for prazosin (+3.8 beats/min). Only atenolol effected a further reduction of heart rate for patients whose baseline rate was ≤65 beats/min. All drugs reduced heart rate when the baseline was ≤85 beats/min. Data derived by electrocardiogram yielded similar results. The drugs used in this study differ in their ability to reduce heart rate, sustain that reduction over time, and to change heart rate in groups with high or low rates at baseline. The importance of these comparative changes as independent cardiac risk factor variables remains to be determined.

Original languageEnglish
Pages (from-to)597-601
Number of pages5
JournalAmerican Journal of Hypertension
Volume11
Issue number5
DOIs
StatePublished - May 1 1998

Fingerprint

Antihypertensive Agents
Heart Rate
Atenolol
Prazosin
Clonidine
Electrocardiography
Placebos
Pharmaceutical Preparations
Hydrochlorothiazide
Diltiazem
Veterans
Randomized Controlled Trials
Hypertension

Keywords

  • Atenolol
  • Captopril
  • Clonidine
  • Diltiazem
  • Heart rate
  • Hydrochlorothiazide
  • Hypertension
  • Placebo
  • Prazosin

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Comparison of effects of antihypertensive drugs on heart rate : Changes from baseline by baseline group and over time. / Materson, Barry J; Reda, Domenic J.; Williams, David W.

In: American Journal of Hypertension, Vol. 11, No. 5, 01.05.1998, p. 597-601.

Research output: Contribution to journalArticle

Materson, Barry J ; Reda, Domenic J. ; Williams, David W. / Comparison of effects of antihypertensive drugs on heart rate : Changes from baseline by baseline group and over time. In: American Journal of Hypertension. 1998 ; Vol. 11, No. 5. pp. 597-601.
@article{ff703dbc91ed4c0fbf11a6840586ad73,
title = "Comparison of effects of antihypertensive drugs on heart rate: Changes from baseline by baseline group and over time",
abstract = "Baseline heart rate is becoming recognized as a predictor of cardiovascular risk. Various antihypertensive drugs have differing effects on heart rate. A randomized controlled clinical trial of 1292 ambulatory men with stage 1 or 2 hypertension was conducted in 15 Veterans Affairs medical centers. Patients were treated with hydrochlorothiazide, atenolol, captopril, clonidine, diltiazem, prazosin, or placebo for up to 2 years. Heart rates were measured at baseline, the end of titration, 1 year, and 2 years. Data were also stratified by baseline heart rate. A subset of patients had heart rate also determined by electrocardiogram. All drugs except prazosin reduced heart rate from baseline; additional small decreases were obtained over time with hydrochlorothiazide and placebo. The decrease initially achieved with clonidine was attenuated over time. The overall reduction in heart rate was greatest for atenolol (-12.2 beats/min) and least for prazosin (+3.8 beats/min). Only atenolol effected a further reduction of heart rate for patients whose baseline rate was ≤65 beats/min. All drugs reduced heart rate when the baseline was ≤85 beats/min. Data derived by electrocardiogram yielded similar results. The drugs used in this study differ in their ability to reduce heart rate, sustain that reduction over time, and to change heart rate in groups with high or low rates at baseline. The importance of these comparative changes as independent cardiac risk factor variables remains to be determined.",
keywords = "Atenolol, Captopril, Clonidine, Diltiazem, Heart rate, Hydrochlorothiazide, Hypertension, Placebo, Prazosin",
author = "Materson, {Barry J} and Reda, {Domenic J.} and Williams, {David W.}",
year = "1998",
month = "5",
day = "1",
doi = "10.1016/S0895-7061(97)00495-0",
language = "English",
volume = "11",
pages = "597--601",
journal = "Journal of clinical hypertension",
issn = "0895-7061",
publisher = "Oxford University Press",
number = "5",

}

TY - JOUR

T1 - Comparison of effects of antihypertensive drugs on heart rate

T2 - Changes from baseline by baseline group and over time

AU - Materson, Barry J

AU - Reda, Domenic J.

AU - Williams, David W.

PY - 1998/5/1

Y1 - 1998/5/1

N2 - Baseline heart rate is becoming recognized as a predictor of cardiovascular risk. Various antihypertensive drugs have differing effects on heart rate. A randomized controlled clinical trial of 1292 ambulatory men with stage 1 or 2 hypertension was conducted in 15 Veterans Affairs medical centers. Patients were treated with hydrochlorothiazide, atenolol, captopril, clonidine, diltiazem, prazosin, or placebo for up to 2 years. Heart rates were measured at baseline, the end of titration, 1 year, and 2 years. Data were also stratified by baseline heart rate. A subset of patients had heart rate also determined by electrocardiogram. All drugs except prazosin reduced heart rate from baseline; additional small decreases were obtained over time with hydrochlorothiazide and placebo. The decrease initially achieved with clonidine was attenuated over time. The overall reduction in heart rate was greatest for atenolol (-12.2 beats/min) and least for prazosin (+3.8 beats/min). Only atenolol effected a further reduction of heart rate for patients whose baseline rate was ≤65 beats/min. All drugs reduced heart rate when the baseline was ≤85 beats/min. Data derived by electrocardiogram yielded similar results. The drugs used in this study differ in their ability to reduce heart rate, sustain that reduction over time, and to change heart rate in groups with high or low rates at baseline. The importance of these comparative changes as independent cardiac risk factor variables remains to be determined.

AB - Baseline heart rate is becoming recognized as a predictor of cardiovascular risk. Various antihypertensive drugs have differing effects on heart rate. A randomized controlled clinical trial of 1292 ambulatory men with stage 1 or 2 hypertension was conducted in 15 Veterans Affairs medical centers. Patients were treated with hydrochlorothiazide, atenolol, captopril, clonidine, diltiazem, prazosin, or placebo for up to 2 years. Heart rates were measured at baseline, the end of titration, 1 year, and 2 years. Data were also stratified by baseline heart rate. A subset of patients had heart rate also determined by electrocardiogram. All drugs except prazosin reduced heart rate from baseline; additional small decreases were obtained over time with hydrochlorothiazide and placebo. The decrease initially achieved with clonidine was attenuated over time. The overall reduction in heart rate was greatest for atenolol (-12.2 beats/min) and least for prazosin (+3.8 beats/min). Only atenolol effected a further reduction of heart rate for patients whose baseline rate was ≤65 beats/min. All drugs reduced heart rate when the baseline was ≤85 beats/min. Data derived by electrocardiogram yielded similar results. The drugs used in this study differ in their ability to reduce heart rate, sustain that reduction over time, and to change heart rate in groups with high or low rates at baseline. The importance of these comparative changes as independent cardiac risk factor variables remains to be determined.

KW - Atenolol

KW - Captopril

KW - Clonidine

KW - Diltiazem

KW - Heart rate

KW - Hydrochlorothiazide

KW - Hypertension

KW - Placebo

KW - Prazosin

UR - http://www.scopus.com/inward/record.url?scp=0031839811&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0031839811&partnerID=8YFLogxK

U2 - 10.1016/S0895-7061(97)00495-0

DO - 10.1016/S0895-7061(97)00495-0

M3 - Article

C2 - 9633797

AN - SCOPUS:0031839811

VL - 11

SP - 597

EP - 601

JO - Journal of clinical hypertension

JF - Journal of clinical hypertension

SN - 0895-7061

IS - 5

ER -