Document Detail

On the combination of alpha- and beta-adrenoceptor blockade in hypertension.
MedLine Citation:
PMID:  6627819     Owner:  NLM     Status:  MEDLINE    
A randomized double-blind crossover trial was conducted in 20 patients with moderate to severe hypertension to compare the efficacy of labetalol, which combines alpha- and beta-adrenoceptor blocking properties, with that of metoprolol alone or in combination with prazosin. After placebo for 1 wk, active medication was given in two 6-wk phases. During one phase, metoprolol (100 to 400 mg/day) was given with prazosin (2 to 4 mg/day) as an option in the last 3 wk, whereas during the other phase, labetalol (200 to 1000 mg/day) was given alone. Satisfactory control of supine blood pressure was obtained in 10 patients with metoprolol and in another four patients after the addition of prazosin. During the labetalol phase, blood pressure control was achieved in 11 of 19 patients tested. Gastrointestinal disturbances, nasal congestion, impotence, failure to ejaculate, scalp tingling, and headache were more prevalent in the labetalol phase than in the other. In four cases these occurred in patients who did not require prazosin. Supine, erect, and exercise pulse rates were reduced by both metoprolol with or without prazosin and by labetalol; the effects were less in the labetalol phase. These differences could arise from an action of labetalol on cardiac presynaptic alpha-adrenoceptors. Adjunctive use of prazosin in nonresponders to metoprolol increases the response rate and avoids unnecessary deployment of alpha-adrenoceptor blockade in patients whose blood pressure can be controlled by beta-blockade alone.
G S Stokes; B A Mennie; R Gellatly; A Hill
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Clinical pharmacology and therapeutics     Volume:  34     ISSN:  0009-9236     ISO Abbreviation:  Clin. Pharmacol. Ther.     Publication Date:  1983 Nov 
Date Detail:
Created Date:  1983-12-17     Completed Date:  1983-12-17     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:  576-82     Citation Subset:  AIM; IM    
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MeSH Terms
Double-Blind Method
Drug Evaluation
Drug Therapy, Combination
Ethanolamines / therapeutic use*
Hypertension / drug therapy*
Labetalol / adverse effects,  therapeutic use*
Metoprolol / adverse effects,  therapeutic use*
Middle Aged
Prazosin / adverse effects,  therapeutic use*
Quinazolines / therapeutic use*
Random Allocation
Reg. No./Substance:
0/Ethanolamines; 0/Quinazolines; 19216-56-9/Prazosin; 36894-69-6/Labetalol; 37350-58-6/Metoprolol

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

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