Pharmacologic considerations in determining efficacy of once-daily sotalol administration to hypertensive patients.

The beta-adrenergic blocker sotalol, administered only once a day, proved an extremely effective and safe agent for the 24-hour control of essential hypertension, even in patients with a severe form of the disease. Significant (P less than 0.01) decreases from the baseline levels were noted in both supine and standing blood pressures as early as the first week after sotalol administration in the 15 patients who participated in the open study. All patients were titrated and controlled by six to eight weeks or sooner. By the conclusion of the 12-week study, mean supine systolic blood pressure in the 15 patients fell 21 per cent (from 176 mm Hg to 139 mm Hg), and mean supine diastolic blood pressure was down 23 per cent (from 115 mm Hg to 89 mm Hg). Standing values were similarly decreased by sotalol administration at a mean daily dose of 341 mg. Two of the patients also received concomitant 25 mg hydrochlorothiazide per day, and four received 40 mg furosemide per day. A comparison with the pretherapy placebo values indicates that all the declines were highly significant (P less than 0.001). Sotalol was very well tolerated, an no adverse reactions were reported during the entire study. There were also no significant changes in laboratory findings except for a drop in serum cholesterol.