Labetalol in severe and resistant hypertension.

Abstract

1 The efficacy of labetalol in the treatment of severe hypertension (diastolic > 115 mm Hg) was studied retrospectively. Ten patients were followed for more than 6 months. At 6 months, eight were well controlled and the mean dose in those was 975 mg daily. Four of these were receiving labetalol alone; two were on labetalol and diuretic only. 2 Three patients were resistant to doses to 1600, 1800 and 2400 mg daily respectively; two of these were controlled with increased doses of vasodilator drugs. In two cases labetalol had produced large falls in the standing BP while not influencing the supine BP. 3 Three other resistant patients were seen, of whom one merely required an increase in dose to 2200 mg daily and the addition of a diuretic. Both the others were elderly, had severe vascular disease, and suffered disabling postural hypotension on a dose of labetalol which did not influence the supine BP. 4 Labetalol can control severe hypertension. There remain patients whose supine BP is not influenced by a dose of labetalol which produces marked postural hypotension.

Labetalol, an alpha‐ and beta‐adrenoceptor‐blocking agent: its use in therapeutics. A summary of the symposium.

“…Long term studies of renal function in hypertensive patients who had pre-existing compromised renal function have shown that labetalol treatment per se does not have any deliterious effect on the underlying renal function (Thompson et al, 1979;Bailey, 1979;Williams, 1979). It can be used alone or together with diuretics (Bailey, 1979), the dose of labetalol required to control BP being reduced due to the additive effect of the diuretic.…”

“…In those patients whose BP is difficult to control or when substitution is required for multiple drug treatments, it is now clear that labetalol may be useful (Williams et al, 1979;Bailey, 1979;New Zealand Hypertension Study Group, 1979). Long term studies of renal function in hypertensive patients who had pre-existing compromised renal function have shown that labetalol treatment per se does not have any deliterious effect on the underlying renal function (Thompson et al, 1979;Bailey, 1979;Williams, 1979).…”

“…Recent data have confirmed that the antihypertensive effect of labetalol is as therapeutically effective as that of methyldopa (Sanders et al, 1979). Earlier work has indicated that labetalol is more potent as an antihypertensive agent than weight for weight comparability with propranolol as a fl-blocker had inferred (Pugsley et al, 1976 (Dargie et al, 1976;New Zealand Hypertension Group 1979;Williams et al, 1979). blood flow induced by labetalol in contrast to diazoxide (Pearson et al, 1979).…”