Betaxolol in elderly patients in primary care

Barbara Gryglewska, Tomasz Grodzicki

Summary
The object of the study was to evaluate the effectiveness and tolerance of betaxolol in elderly patients with hypertension (HT) and/or coronary heart disease (CHD) in primary care.
Material and methods: An open study was carried out in general practice. Treatment using betaxolol (Lokren, Sanofi-Synthelabo) was given in a dose of 10-40 mg daily to patients with CHD and HT, not taking b-blockers and without contraindications. The treatment was continued over 8 weeks. At the beginning and end of the study, measurements of blood pressure, heart rate, and weight were performed in addition to a questionnaire related to the history of HT and CHD, medicines, concomitant diseases and risk factors of CV diseases. Effectiveness and tolerance were assessed by the physician (using a 4-point scale) and the patient (3-point scale).
Results: A total of 2839 patients (42%M) aged between 60 – 93 years (mean 68±5.8) were enrolled. Blood pressure values at entry were 167.1±18.6/97.9±10.2 mmHg and heart rate was 83±10.5 beats/min. Almost all subjects (97%) suffered from hypertension, and 67% of them were diagnosed as having CHD (22% after myocardial infarction). Other complications of hypertension are retinopathy (49%) or left ventricular hypertrophy confirmed by electrocardiography or echocardiography (65%). Concomitant diabetes was diagnosed in 22% studied. Family history of hypertension was confirmed in 59% subjects. Betaxolol was mainly used at a dose of 20 mg (63%) or 10mg (36%) daily. The drug was most often added to antihypertensive (91%), lipid-lowering (50%), and anti-platelet (51%) treatment. Treatment led to a significant drop in blood pressure from 167.1±18.6/97.9±10.2 to 141.4±13.7/84±8.3 mmHg, accompanied by a reduction in heart rate from 83±10.5 beats/min. to 70.3±8.4ud/min. at good (59%) or very good (35%) tolerance and effectiveness (good – 57%; very good – 34 %). Only 3% of the studied patients did not reach normal values of systolic blood pressure, and 12% of diastolic blood pressure. Side effects occurred only in 7% of the patients (mainly bradycardia <50 beats/min – 1.5%, headaches and dizziness – 1.2%, weakness – 0.7%. Health condition improved in in the opinion of the majority of patient (74%). Treated subjects did not report any deterioration of sleep quality (no change – 62%, improvement – 35%), mood (no change – 64%, improvement – 34%), physical efficacy (no-change – 62%, improvement – 36%) or sexual performance (94%).
Conclusions: Betaxolol is a safe and effective medication in the treatment of elderly patients with hypertension and coronary heart disease in primary care.

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