Acebutolol is a new hydrophilic, cardioselective
beta-adrenergic-blocking agent that possesses partial agonist and membrane-stabilizing activities. In the treatment of mild to moderate
essential hypertension, once-daily
acebutolol as monotherapy provides effective control in a large majority of patients and produces a further reduction in blood pressure when used concomitantly with
diuretics.
Acebutolol is as effective as other beta-blocking agents, and in a large, double-blind, parallel study against
propranolol was found to cause less reduction in heart rate, and fewer neurologic side effects and patient withdrawals due to adverse effects. Oral
acebutolol is also effective in suppressing
premature ventricular contractions, and in small numbers of patients generally beneficial results were obtained in supraventricular and ventricular arrhythmias with
intravenous administration. These salutary effects are attributable to beta blockade. Controlled clinical trials documented the antianginal actions of oral
acebutolol in
chronic stable angina pectoris; its efficacy in this regard is comparable to that of other beta-blocking agents. The
drug produces smaller decreases in heart rate and cardiac output and alterations in peripheral vascular hemodynamics than beta-blocking drugs without partial agonist activity, and because of its cardioselectivity, it may be used cautiously in patients with bronchospastic disease.
Acebutolol has minimal metabolic effects and does not elevate levels of blood
lipids during long-term
therapy;
high-density-lipoprotein cholesterol increased with
acebutolol in a small number of patients.