89107
document
Topical beta-blockade with intrinsic sympathomimetic activity offers no advantage for the respiratory and cardiovascular function of elderly people . Topical therapy with beta-antagonists , such as timolol , may cause unrecognized impairment of respiratory and cardiovascular function in elderly people . Beta-antagonists with intrinsic sympathomimetic or cardioselective properties , such as carteolol or betaxolol , may cause less impairment . In a randomized , double-masked study of glaucoma patients , over 60 years of age , without history of bronchospasm and who were using timolol ( 0.5 % ) , 60 patients were allocated to betaxolol ( 0.5 % ) or carteolol ( 2 % ) or continued timolol ( 0.5 % ) treatment . Spirometry , pulse and blood pressure were measured on enrollment and after 4 weeks . In the timolol and carteolol groups there were no significant changes in mean spirometric values . Changing to betaxolol improved mean peak flow ( PF ) by 9.1 % , from 310 to 3411/min ( p < 0.05 ) and forced expiratory volume in 1 second ( FEV1 ) by 9.4 % , from 1.74 to 1.861 ( p < 0.05 ) . Differences in the changes in PF and FEV1 between betaxolol and timolol as well as betaxolol and carteolol groups were statistically significant ( p < 0.05 ) . Twenty-one per cent of those allocated to betaxolol showed clinically significant improvement in FEV1 . There was no change in pulse or blood pressure when carteolol was substituted for timolol but an increase of 10 beats per minute ( p < 0.05 ) in mean resting pulse in the betaxolol group . Therapy with cardioselective beta-blockade may offer significant advantages in respiratory function for elderly people with glaucoma over non-selective drugs , even if they have sympathomimetic activity .
89108
Intervention_Pharmacological
timolol
89109
Intervention_Pharmacological
carteolol
89110
Intervention_Pharmacological
betaxolol
89111
Intervention_Pharmacological
timolol
89112
Intervention_Pharmacological
betaxolol
89113
Intervention_Pharmacological
carteolol
89114
Intervention_Pharmacological
timolol
89115
Outcome_Physical
Spirometry , pulse and blood pressure
89116
Outcome_Physical
mean spirometric values .
89117
Outcome_Physical
mean peak flow ( PF )
89118
Outcome_Physical
forced expiratory volume
89119
Outcome_Mental
changes in PF and FEV1
89120
Outcome_Physical
FEV1 .
89121
Outcome_Physical
pulse or blood pressure
89122
Outcome_Other
mean resting pulse
89123
Participant_Condition
elderly people .