Labetalol in the treatment of elderly patients with mild essential hypertension

Nugent, C. A.; Bleicher, J. M.; Plachetka, J. R.

Fifty-two elderly hypertensive patients with standing diastolic (90-110 mm Hg) or systolic (160-240 mm Hg) blood pressure elevations were assigned randomly to receive labetalol or placebo in a double-blind study. Baseline standing blood pressure in the two groups were similar. The goal of treatment was to reduce standing pressure to < 150/< 90 mm Hg (or, for systolic pressure, a decrease of at least 10%). If blood pressure was uncontrolled after labetalol or placebo use for four weeks, hydrochlorothiazide (HCTZ) was added. During the titration phase, goal blood pressure was achieved by all 25 patients receiving labetalol, and 20 of these 25 required < 200 mg twice a day. No patient receiving labetolol required addition of HCTZ. By contrast, HCTZ was required by 12 of 25 (48%) placebo patients, eight of whom were controlled by the end of titration. By the end of the four-week maintenance phase, 18 of 25 (72%) patients receiving labetalol and 10 of 21 (48%) patients receiving placebo or placebo and HCTZ had blood pressures with the target range (P < .05). No patient withdrew because of drug-related adverse events. Labetolol in low dosages appears to be an effective and well-tolerated antihypertensive monotherapy in elderly patients.