Why the study?
Does labetalol provide equivalent anti-hypertensive effects and a distinct haemodynamic profile compared to other anti-hypertensive drugs?
Does labetalol provide equivalent anti-hypertensive effects and a distinct haemodynamic profile compared to other anti-hypertensive drugs?
Labetalol is an effective anti-hypertensive agent with a unique dual alpha- and beta-blocking haemodynamic profile and comparable overall side-effect burden to other anti-hypertensives, though high doses risk postural hypotension.
Supports labetalol as an equivalent option in hypertension; leaves open its role versus contemporary agents in trials.
1 The anti-hypertensive effects of labetalol have been compared and contrasted with other groups of anti-hypertensive drugs in this review of the published literature. 2 The data show that the pharmacological and haemodynamic profile of labetalol in man is distinctly different from that of other specific anti-hypertensive agents; namely the properties of competitive alpha-and beta-adrenoceptor blockade leading to haemodynamic effects of reduced blood pressure and peripheral vascular resistance with little accompanying changes in resting heart rate or cardiac output. 3 The anti-hypertensive effects of labetalol are dose related. In fixed dose comparative studies equivalent anti-hypertensive effects to those of labetalol have been shown for individual drugs of the beta-adrenoceptor-blocking and diuretic groups. In dose titration studies, equivalent anti-hypertensive effects at given doses of labetalol have been demonstrated for drugs of the following types: beta-adrenoceptor blockers, beta-blockers plus diuretics, methyldopa, adrenergic neurone blockers and the combination of beta-blockers plus a peripheral vasodilator. 4 Comparing side-effect liabilities, it is clear that quantitatively labetalol produces no greater burden of side-effects than drugs of the beta-adrenoceptor-blocking group. Qualitative differences, however, do exist; in particular, symptomatic postural hypotension is dose related and is more likely to occur when excessive doses (greater than 2 g daily) are used.
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Prichard et al. (1982) studied this question.
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