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

P. A. Netland, H. S. Weiss, W. C. Stewart, J. S. Cohen, L. L. Nussbaum, D. Abrams, G. Schwartz, P. Hughes, A. Adelson, M. Brink, M. Myers, R. Bahr, Jr Dowling, F. Richards, A. Geltzer, R. J. Hoffmann, L. Snady-McCoy, L. A. Bartnik, J. Beneke, L. BarrD. Muroski, J. Neal, C. Clevenger, B. Summit, A. Lee, J. Cohen, K. A. Riccio, A. Luechauer, H. DuBiner, S. Cribbs, R. Laibovitz, K. Neck, T. Mundorf, D. Otero, P. A. Netland, D. A. Vivolo, L. Schwartz, P. Carmichael, R. Conner, T. Nowinski, J. Kesselring, A. Bollenbach, A. Foley, W. Stewart, J. Stewart, H. Weiss, A. Schwartz, B. D. Latham

Research output: Contribution to journalArticle

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.

Original languageEnglish (US)
Pages (from-to)465-477
Number of pages13
JournalAmerican journal of ophthalmology
Volume123
Issue number4
DOIs
StatePublished - Jan 1 1997

ASJC Scopus subject areas

  • Ophthalmology

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    Netland, P. A., Weiss, H. S., Stewart, W. C., Cohen, J. S., Nussbaum, L. L., Abrams, D., Schwartz, G., Hughes, P., Adelson, A., Brink, M., Myers, M., Bahr, R., Dowling, J., Richards, F., Geltzer, A., Hoffmann, R. J., Snady-McCoy, L., Bartnik, L. A., Beneke, J., ... Latham, B. D. (1997). Cardiovascular effects of topical carteolol hydrochloride and timolol maleate in patients with ocular hypertension and primary open-angle glaucoma. American journal of ophthalmology, 123(4), 465-477. https://doi.org/10.1016/S0002-9394(14)70172-2