They were seen in the morning 24 ±2 h after receiving the last dose of medication. Arterial pressure was taken in triplicate in the supine (5 min) and the upright positions (2 min) and the values were averaged. The heart rate was taken once. After a two- to four-week baseline period of only diuretic monotherapy (furosemide 40 mg/day), patients were randomized to either betaxolol (20 mg/day) or atenolol (50 mg/day) if their supine diastolic arterial pressure (SDAP) was 105 to 125 mm Hg inclusive. Patients with severe hypertension (SDAP^ 116 mm Hg) were randomized after two weeks of baseline observation. However, this was considered week 4 for the purposes of analysis of results. At week 6 of the treatment period, if the SDAP was >95 mm Hg or greater, minoxidil, 2.5 mg/ day, was added. Depending on arterial pressure response (SDAP>90 mm Hg), the dosages were increased to 80 mg/day for betaxolol, 200 mg/day for atenolol, and 20 mg/day for minoxidil up to week 16. Thereafter no changes were permitted. Increases in the dosage of furosemide, only for edema, were also allowed during this titration period. Click Here

Complete blood counts, blood chemistry analyses, ANA titers, urinalyses, and ECCs were done at baseline and several times during the study. A complete physical examination, chest x-ray films, and M-mode echocardiograms were done at the end of the baseline (weeks 2 to 4) and at the end of the study (week 32). Spirometric evaluation was done at the end of baseline and at the end of week 6 (end of diuretic p-blocker combination), whereas ambulatory pressures were recorded at the end of baseline and beginning of p-blocker therapy (week 5) by a portable monitor (model 5300 Space-Labs). The monitor was applied at 8 am to the same arm used for clinic arterial pressure measurements and was programmed to take readings every hour for 24 h. The drugs were given after the monitor had been applied, a pressure reading taken, and the time recorded in the patients diary. The patient was also instructed to enter in the diary any important events during the 24-h period, including sleep and waking times. From the chest x-ray films, the cardiothoracic ratios (CTS) were calculated by dividing the largest transverse diameter of the heart by the largest transverse diameter of the chest. From the spirometric studies, the FEV», FVC, and the FEV,/FVC were calculated. From the echocardiograms, the IVS, LVPW, LVIDd, RVIDd, EF, and FS were calculated. In addition, the LVM was calculated by using the Penn convention formula:
LVM = 1.04 [(IVSd + LVIDd + LVPW)3 – (LVIDd)3] – 13.6g
The results were analyzed by a two-way analysis of variance for within-group changes and by an unpaired t test for between-group changes.