Document Detail

Combined alpha/beta-blockade versus beta 1-selective blockade in essential hypertension in black and white patients.
MedLine Citation:
PMID:  2249378     Owner:  NLM     Status:  MEDLINE    
The purpose of this multicenter investigation was to determine the efficacy and safety of the alpha/beta-blocker labetalol versus the beta 1-selective beta-blocker atenolol in white and black patients with essential hypertension. Equal numbers of black and white patients were enlisted to form four treatment groups (white patients taking either labetalol or atenolol and black patients taking either labetalol or atenolol). Two hundred ninety-two patients (152 white and 140 black patients) with essential hypertension characterized by a standing diastolic blood pressure of 105 to 119 mm Hg (inclusive) were recruited for this trial. Patients were randomized to either labetalol (dosage titrated from 200 to 1600 mg/day) or atenolol (dosage titrated from 50 to 100 mg/day). The therapeutic goal was achievement of a standing diastolic blood pressure of 90 mm Hg or less or a fall of 15 mm Hg in diastolic pressure from baseline value at the end of the placebo run in period. At the end of the study there were no significant differences in blood pressure or heart rate changes in the supine position between the labetalol and atenolol groups. In contrast, labetalol produced greater reduction in both the standing systolic and diastolic blood pressure (-12/-13 mm Hg, respectively) compared with atenolol (-7/-9 mm Hg; p less than 0.05; p less than 0.005, respectively). The greatest decrease in blood pressure was observed in white patients receiving labetalol. In black patients the decrease in blood pressure was greater in those treated with labetalol compared with atenolol, particularly with respect to the systolic blood pressure. We conclude that the alpha 1-blocking property of labetalol provides an additional lowering of the blood pressure over that seen with beta 1-blockade alone, especially in the standing position, and this enhanced efficacy is not confined to one radical group.
R R Townsend; D J DiPette; R Goodman; D Blumfield; R Cronin; A Gradman; L A Katz; E P McCarthy; G Sopko
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Clinical pharmacology and therapeutics     Volume:  48     ISSN:  0009-9236     ISO Abbreviation:  Clin. Pharmacol. Ther.     Publication Date:  1990 Dec 
Date Detail:
Created Date:  1991-01-16     Completed Date:  1991-01-16     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0372741     Medline TA:  Clin Pharmacol Ther     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  665-75     Citation Subset:  AIM; IM    
Allegheny General Hospital, Pittsburgh, PA.
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MeSH Terms
African Continental Ancestry Group
Atenolol / adverse effects,  therapeutic use*
Blood Pressure / drug effects
Double-Blind Method
European Continental Ancestry Group
Heart Rate / drug effects
Hypertension / drug therapy*,  physiopathology
Labetalol / adverse effects,  therapeutic use*
Prospective Studies
Reg. No./Substance:
29122-68-7/Atenolol; 36894-69-6/Labetalol

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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