Related Experiment Videos
Evaluation of labetalol in elderly patients with essential hypertension
T D Giles1, M Weber, D W Bartels
1Tulane Medical Center, School of Medicine, New Orleans, LA.
Insights
Labetalol effectively controlled mild to moderate essential hypertension in elderly patients. This study found labetalol safe and effective for lowering blood pressure without significant orthostatic changes.
Area of Science:
- Geriatric Medicine
- Cardiovascular Pharmacology
- Clinical Hypertension Research
Background:
- Essential hypertension is a prevalent condition in elderly populations.
- Managing hypertension in older adults requires careful consideration of efficacy and safety.
- Orthostatic hypotension is a common concern in geriatric antihypertensive therapy.
Purpose of the Study:
- To evaluate the efficacy and safety of labetalol in elderly patients with mild to moderate essential hypertension.
- To assess blood pressure control and orthostatic effects of labetalol treatment.
- To determine the optimal dosage range for labetalol in this demographic.
Main Methods:
- A multicenter, placebo-controlled study involving patients aged 60 years and older.
- A 6-week titration period of labetalol (100-400 mg BID) followed by a 4-week maintenance phase.
- Blood pressure control defined as standing diastolic blood pressure < 90 mm Hg and ≥ 10 mm Hg reduction from baseline.
Main Results:
- Labetalol achieved blood pressure control in 69% of patients, compared to 36% in the placebo group (P < .001).
- 78% of responders on labetalol achieved control with 200 mg BID or less.
- No significant differences in orthostatic blood pressure changes were observed between labetalol and placebo groups.
Conclusions:
- Labetalol is an effective antihypertensive agent for elderly patients with mild to moderate essential hypertension.
- Labetalol demonstrates a favorable safety profile in this population, with similar adverse event rates to placebo.
- The drug effectively lowers diastolic blood pressure without inducing significant orthostatic changes, making it a suitable option for geriatric hypertension management.
Abstract:
Labetalol was evaluated in a multicenter, placebo-controlled study of elderly patients (greater than or equal to 60 years) with mild to moderate essential hypertension. After a placebo-washout period, doses were titrated from 100 mg BID to a maximum of 400 mg BID over a 6-week period. Once blood pressure control (standing diastolic blood pressure [SDBP] less than 90 mm Hg and greater than or equal to 10 mm Hg reduction from baseline) was achieved or the maximum allowable dosage had been given, the dosage remained the same until the end of the study. The titration phase was followed by a 4-week maintenance period. Blood pressure control was achieved in 37/54 (69%) of the patients who were treated with labetalol compared with 21/58 (36%) of the patients who received placebo (P less than .001). Twenty-nine (78%) of those controlled on labetalol responded to doses of 200 mg or less BID, and there was no significant difference between groups with respect to orthostatic blood pressure changes. Adverse experiences were generally mild and occurred with similar frequency in the labetalol and placebo groups; six patients who received labetalol and five who received placebo withdrew from the study due to adverse experiences, but in only one case (labetalol) was the adverse experience considered drug-related. In summary, labetalol effectively and safely lowered diastolic blood pressure in the elderly without producing significant orthostatic changes.