Effects of labetalol and propranolol on the peripheral circulation in hypertensive patients

Eleven patients with essential hypertension participated in a double-blind cross-over comparison of labetalol (L) and propranolol (P). Each drug was given for 5--8 weeks. The dose reducing the supine diastolic blood pressure when given b.d. to or below 90 mm Hg was titrated out. At the end of each period, isometric exercise (sustained handgrip) and calf plethysmography were performed. L (mean daily dose 636 mg) was slightly more effective in lowering supine and standing blood pressure than P (mean dose 276 mg). There was no significant difference between the drugs in their effect on the blood-pressure response to handgrip. However, compared with no treatment, L attenuated the blood-pressure rise at near-maximal handgrip; this has not been reported with other beta-blockers. Resting vascular resistance and basal vascular tone were significantly lower (20%, p less than 0.05) during treatment with labetalol than when the patients were taking propranolol. - The differences may be explained by the alpha-receptorblocking action of labetalol.