Serum Creatine Phosphokinase Levels During Treatment with β-Adrenoreceptor Blocking Agents

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Abstract
Four .beta.-adrenoreceptor blocking agents, pindolol (15 mg/day), propranolol (60 mg/day), carteolol (15 mg/day), and labetalol (150 mg/day), was administered to essential hypertensive patients, and the changes in levels of serum creatine phosphokinase (CPK) and its isoenzymes were followed for 1 yr. Blood pressure was reduced almost equally by all drugs, but the changes in serum CPK levels differed. During treatment with pindolol, 20 of 25 patients showed a 20-760% increase in CPK compared with the pretreatment value. Studies on CPK isoenzymes revealed that the elevation was mainly in the skeletal muscle (MM type), while 8 of the 25 patients also showed a slight increase in the myocardial type (MB type). Another .beta.-blocking agent with intrinsic sympathomimetic activity (ISA), carteolol, also increased the CPK levels significantly in 10 of 15 patients. Such increases were observed in only 4 of 27 patients receiving propranolol and 3 of 9 patients receiving labetalol. .beta.-Blocking agents with ISA increase the serum CPK levels more frequently than those without ISA. The serum CPK levels should be carefully evaluated in patients receiving .beta.-blocking agents, especially those with ISA.