Key result
R,R-labetalol retains beta-1 blockade and matches racemic labetalol in antihypertensive potency.
Why the study?
The cardiovascular properties and stereochemistry of labetalol's four stereoisomers, including their adrenergic blocking activities and antihypertensive effects, were not fully characterized.
A useful method for the separation of labetalol into its two racemic diastereomers, as well as a stereoselective synthesis of its four stereoisomers, is described. The absolute stereochemistry of each isomer was determined by analysis of the DC spectra and confirmed by X-ray analysis. The alpha- and beta 1-adrenergic blocking properties, as well as the relative antihypertensive activities, have been measured in rats. The R,R isomer, 2a (SCH 19927), possesses virtually all of the beta 1-blocking activity elicited by labetalol and displays little alpha-blocking activity. In contrast, the S,R isomer, 3a, has most of the alpha-blocking activity. Of the four isomers, only 2a has antihypertensive potency comparable to that of labetalol. These findings, coupled with published data showing that labetalol possesses beta-adrenergic mediated peripheral vasodilating activity deriving essentially from its R,R isomer, lead to the following conclusion: The antihypertensive activity of labetalol can be ascribed to at least three identified complementary mechanisms, beta-adrenergic blockade, beta-adrenergic mediated vasodilatation, and alpha-adrenergic blockade, whereas the antihypertensive activity of 2a derives from the first two mechanisms only.
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Gold et al. (1982) studied Hypertension (preclinical model). Labetalol stereoisomers (R,R isomer 2a) vs. Racemic labetalol and other stereoisomers was evaluated on Alpha- and beta-1-adrenergic blocking properties and relative antihypertensive activities. The R,R isomer of labetalol possessed virtually all of the beta-1 blocking activity and demonstrated antihypertensive potency comparable to that of racemic labetalol in rat models.
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