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Abstract
Some theoretical arguments suggest that added vasodilation could be beneficial in
the management of patients with systemic hypertension and angina pectoris. Ten patients
were studied in a double-blind crossover trial in which the severity of hypertension
and angina pectoris was monitored. The initial run-in period of 2 to 6 weeks consisted
of therapy with fixed-dose atenolol, 100 mg once daily, a thiazide diuretic drug,
and any other agents required to control the hypertension. Patients were then randomized
for 4 weeks to active atenolol plus 2 tablets of labetalol placebo, or active labetalol
(200 mg twice daily) plus atenolol placebo, then crossed over and then changed back
to active atenolol without labetalol placebo; the observers were unblinded in the
last period. Labetalol and atenolol were equivalent in control of blood pressure at
rest, exercise tolerance and use of nitroglycerin; however, heart rates at rest and
during exercise were higher with labetalol (p < 0.01), whereas the heart rate-blood
pressure product at the end of the exercise test was unchanged with labetalol. The
higher heart rates for the same antianginal efficacy may give an advantage to labetalol
treatment in some patients. Conversely, atenolol is cardioselective, hydrophilic,
and can be given as a single daily dose. Thus, each agent has some advantages in the
therapy of patients with hypertension and effort angina.
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References
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Article Info
Publication History
Accepted:
May 8,
1985
Received in revised form:
May 7,
1985
Received:
February 12,
1985
Identification
Copyright
© 1985 Published by Elsevier Inc.
