Skip to main content
NCBI home page
British Journal of Clinical Pharmacology logoLink to British Journal of Clinical Pharmacology
. 1982;13(Suppl 1):101S–110S. doi: 10.1111/j.1365-2125.1982.tb01897.x

Effects of combined α- and β-blockade by labetalol in patients with coronary artery disease

Mario Condorelli, Gregorio Brevetti, Massimo Chiariello, Domenico Miceli, Guiseppe Lavecchia, Giampaolo Paudice, Salvatore Verrienti
PMCID: PMC1401826  PMID: 7093092

Abstract

1 The effect of labetalol 100 mg orally twice daily on exercise tolerance has been compared with placebo in 19 normotensive subjects with angiographic evidence of coronary artery disease.

2 Labetalol, at the same work load as during placebo exercise, significantly reduced systolic and diastolic blood pressures, as well as heart rate and rate-pressure product.

3 Similarly, ST segment depression was reduced by labetalol from 2.0 ± 0.4 to 1.36 ± 0.6 mm (P<0.001), thus enabling an increase in exercise tolerance from a control value of 83.7 ± 18 to 95.3 ± 19 W (P<0.005).

4 In seven other patients, also with coronary artery disease, the haemodynamic effects of a single 0.6 mg/kg intravenous dose of the drug was evaluated during exercise.

5 Compared with conditions during control exercise, labetalol induced a significant reduction in rate-pressure product from 17228 ± 2375 to 13445 ± 2404 mmHg/min (P<0.005) and in peripheral vascular resistance from 612.0 ± 61.2 to 512.7 ± 36.2 dyn cm-5 m-2 (P<0.0025). These events were not accompanied by any change in cardiac index and in dP/dT left ventricular end-diastolic pressure (LVEDP) ratio.

6 These data suggest that labetalol may induce reduction in myocardial oxygen consumption, thereby increasing exercise tolerance in patients with coronary artery disease, without impairment of left ventricular performance.

Full text

PDF
101S

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Brittain R. T., Levy G. P. A review of the animal pharmacology of labetalol, a combined alpha- and beta-adrenoceptor-blocking drug. Br J Clin Pharmacol. 1976 Aug;3(4 Suppl 3):681–684. [PubMed] [Google Scholar]
  2. Chiariello M., Brevetti G., DeRosa G., Acunzo R., Petillo F., Rengo F., Condorelli M. Protective effects of simultaneous alpha and beta adrenergic receptor blockade on myocardial cell necrosis after coronary arterial occlusion in rats. Am J Cardiol. 1980 Aug;46(2):249–254. doi: 10.1016/0002-9149(80)90065-x. [DOI] [PubMed] [Google Scholar]
  3. Collier J. G., Dawnay N. A., Nachev C., Robinson B. F. Clinical investigation of an antagonist at alpha- and beta-adrenoceptors-AH5158A. Br J Pharmacol. 1972 Feb;44(2):286–293. doi: 10.1111/j.1476-5381.1972.tb07265.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Farmer J. B., Kennedy I., Levy G. P., Marshall R. J. Pharmacology of AH 5158; a drug which blocks both - and -adrenoceptors. Br J Pharmacol. 1972 Aug;45(4):660–675. doi: 10.1111/j.1476-5381.1972.tb08125.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Franciosa J. A., Limas C. J., Guiha N. H., Rodriguera E., Cohn J. N. Improved left ventricular function during nitroprusside infusion in acute myocardial infarction. Lancet. 1972 Mar 25;1(7752):650–654. doi: 10.1016/s0140-6736(72)90460-6. [DOI] [PubMed] [Google Scholar]
  6. Frick M. H., Pörsti P. Combined alpha- and beta-adrenoceptor blockade with labetalol in hypertension. Br Med J. 1976 May 1;1(6017):1046–1048. doi: 10.1136/bmj.1.6017.1046. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Gold H. K., Leinbach R. C., Sanders C. A. Use of sublingual nitroglycerin in congestive failure following acute myocardial infarction. Circulation. 1972 Nov;46(5):839–845. doi: 10.1161/01.cir.46.5.839. [DOI] [PubMed] [Google Scholar]
  8. Helfant R. H., Herman M. V. Abnormalities of left ventricular contraction induced by beta adrenergic blockade. Circulation. 1971 May;43(5):641–647. doi: 10.1161/01.cir.43.5.641. [DOI] [PubMed] [Google Scholar]
  9. Jackson G., Harry J. D., Robinson C., Kitson D., Jewitt D. E. Comparison of atenolol with propranolol in the treatment of angina pectoris with special reference to once daily administration of atenolol. Br Heart J. 1978 Sep;40(9):998–1004. doi: 10.1136/hrt.40.9.998. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Koch G. Acute hemodynamic effects of an alpha- and beta-receptor blocking agent (AH 5158) on the systemic and pulmonary circulation at rest and during exercise in hypertensive patients. Am Heart J. 1977 May;93(5):585–591. doi: 10.1016/s0002-8703(77)80008-2. [DOI] [PubMed] [Google Scholar]
  11. Majid P. A., Meeran M. K., Benaim M. E., Sharma B., Taylor S. H. Alpha- and beta-adrenergic receptor blockade in the treatment of hypertension. Br Heart J. 1974 Jun;36(6):588–596. doi: 10.1136/hrt.36.6.588. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Majid P. A., Sharma B., Taylor S. H. Phentolamine for vasodilator treatment of severe heart-failure. Lancet. 1971 Oct 2;2(7727):719–724. doi: 10.1016/s0140-6736(71)92098-8. [DOI] [PubMed] [Google Scholar]
  13. Mehta J., Cohn J. N. Hemodynamic effects of labetalol, an alpha and beta adrenergic blocking agent, in hypertensive subjects. Circulation. 1977 Feb;55(2):370–375. doi: 10.1161/01.cir.55.2.370. [DOI] [PubMed] [Google Scholar]
  14. Miller R. R., Olson H. G., Pratt C. M., Amsterdam E. Z., Mason D. T. Efficacy of beta adrenergic blockade in coronary heart disease: propranolol in angina pectoris. Clin Pharmacol Ther. 1975 Nov;18(5 Pt 1):598–605. doi: 10.1002/cpt1975185part1598. [DOI] [PubMed] [Google Scholar]
  15. Prichard B. N., Boakes A. J. Labetalol in long-term treatment of hypertension. Br J Clin Pharmacol. 1976 Aug;3(4 Suppl 3):743–750. [PubMed] [Google Scholar]
  16. Rod J. L., Admon D., Kimchi A., Gotsman M. S., Lewis B. S. Evaluation of the beta-blocking drug acebutolol in angina pectoris. Am Heart J. 1979 Nov;98(5):604–612. doi: 10.1016/0002-8703(79)90286-2. [DOI] [PubMed] [Google Scholar]
  17. Stephen S. A. Unwanted effects of propranolol. Am J Cardiol. 1966 Sep;18(3):463–472. doi: 10.1016/0002-9149(66)90071-3. [DOI] [PubMed] [Google Scholar]
  18. Turner G. G., Nelson R. R., Nordstrom L. A., Diefenthal H. C., Gobel F. L. Comparative effect of nadolol and propranolol on exercise tolerance in patients with angina pectoris. Br Heart J. 1978 Dec;40(12):1361–1370. doi: 10.1136/hrt.40.12.1361. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from British Journal of Clinical Pharmacology are provided here courtesy of British Pharmacological Society

RESOURCES