Cardiovascular effects of topical carteolol hydrochloride and timolol maleate in patients with ocular hypertension and primary open-angle glaucoma. Night Study Group

Am J Ophthalmol. 1997 Apr;123(4):465-77. doi: 10.1016/s0002-9394(14)70172-2.

Abstract

Purpose: To compare the effects of topical timolol maleate 0.5% and carteolol hydrochloride 1% on pulse rate and blood pressure.

Methods: In a randomized, double-masked, parallel-design, multicenter clinical trial, we compared the effects of timolol and carteolol on pulse rate and blood pressure measured by 24-hour ambulatory blood pressure monitoring in 169 adult patients with either ocular hypertension or primary open-angle glaucoma.

Results: From noon to 8 PM, baseline mean pulse rate of 82 to 83 beats per minute (bpm) had decreased by 4 to 6 bpm in both groups after 4 weeks of therapy with timolol or carteolol. From midnight to 4 AM, the pulse rate in the carteolol group was significantly above baseline (P = .005), while the timolol group was significantly below baseline (P < .001). Four times as many patients became bradycardic (heart rate, < 60 bpm) on timolol (18.4%) as did patients on carteolol (4.5%) from midnight to 4 AM. More than twice as many patients exhibited a resolution of their bradycardia with carteolol (46.7%) as did patients treated with timolol (18.2%) from midnight to 4 AM. Overall cardiovascular adverse effects were reported significantly more frequently in the timolol than the carteolol group (P = .002).

Conclusions: Timolol causes significantly lower mean heart rate during the nighttime and more nocturnal bradycardia than carteolol does in patients with ocular hypertension and primary open-angle glaucoma. These differences may be because of the intrinsic sympathomimetic activity of carteolol.

Publication types

  • Clinical Trial
  • Comparative Study
  • Multicenter Study
  • Randomized Controlled Trial

MeSH terms

  • Administration, Topical
  • Adrenergic beta-Antagonists / administration & dosage
  • Adrenergic beta-Antagonists / adverse effects
  • Adrenergic beta-Antagonists / therapeutic use*
  • Adult
  • Aged
  • Blood Pressure / drug effects*
  • Blood Pressure / physiology
  • Blood Pressure Monitoring, Ambulatory
  • Carteolol / administration & dosage
  • Carteolol / adverse effects
  • Carteolol / therapeutic use*
  • Double-Blind Method
  • Female
  • Glaucoma, Open-Angle / drug therapy*
  • Glaucoma, Open-Angle / physiopathology
  • Heart Rate / drug effects*
  • Heart Rate / physiology
  • Humans
  • Male
  • Middle Aged
  • Ocular Hypertension / drug therapy*
  • Ocular Hypertension / physiopathology
  • Ophthalmic Solutions
  • Timolol / administration & dosage
  • Timolol / adverse effects
  • Timolol / therapeutic use*
  • Visual Acuity

Substances

  • Adrenergic beta-Antagonists
  • Ophthalmic Solutions
  • Timolol
  • Carteolol