Carvedilol , within the recommended dose range , did not show a significant dose response effect for SBP or DBP .
Carvedilol had little or no effect on pulse pressure ( -1 mm Hg ) and did not change BP variability .
Due to the larger sample size from the two unpublished studies , carvedilol provided a better estimate of BP lowering effect than labetalol .
Doses higher than the recommended starting dose did not provide additional BP reduction .
Higher doses of dual receptor blockers caused more bradycardia than lower doses .
Based on indirect comparison with other classes of drugs , the blood pressure lowering effect of dual alpha- and beta-receptor blockers is less than non-selective , beta1 selective and partial agonist beta blockers , as well as thiazides and drugs inhibiting the renin angiotensin system .
Dual blockers also had little or no effect on reducing pulse pressure , which is similar to the other beta-blocker classes , but less than the average reduction of pulse pressure seen with thiazides and drugs inhibiting the renin angiotensin system .
Patients taking dual receptor blockers  were not more likely to withdraw from the study compared to patients taking placebo
BACKGROUND Drugs with combined alpha and beta blocking activity are commonly prescribed to treat hypertension .
However , the blood pressure ( BP ) lowering efficacy of this class of beta blockers has not been systematic ally review ed and quantified .
OBJECTIVES To quantify the dose-related effects of various types of dual alpha and beta adrenergic receptor blockers ( dual receptor blockers ) on systolic and diastolic blood pressure versus placebo in patients with primary hypertension .
Effect of Carvedilol on Ambulatory Blood Pressure, Renal Hemodynamics, and Cardiac Function in Essential Hypertension
Summary : A r and omized , double‐blind , placebo‐controlled study was set up to study the effects of acute and chronic administration of  carvedilol  , a vasodilatory & bgr;‐blocker in essential hypertension . Acute administration of a single dose of 50 mg of carvedilol reduced systolic and diastolic blood pressure , without inducing reflex tachycardia . Renal blood flow was preserved : accordingly renal vascular resistance was significantly reduced . A significant reduction of glomerular filtration rate and filtration fraction was observed . Plasma renin activity ( PRA ) and plasma aldosterone were not changed . Chronic carvedilol treatment produced a significant fall in systolic and diastolic office and ambulatory blood pressure , heart rate , cardiac output , PRA and plasma aldosterone . Blood pressure variability was not changed . Renal blood flow , glomerular filtration rate and filtration fraction also remained unchanged ; renal vascular resistance decreased significantly . It is concluded that carvedilol possesses definite antihypertensive and renal vasodilating properties , both acutely and after chronic treatment
Carvedilol , within the recommended dose range , did not show a significant dose response effect for SBP or DBP .
Carvedilol had little or no effect on pulse pressure ( -1 mm Hg ) and did not change BP variability .
Due to the larger sample size from the two unpublished studies , carvedilol provided a better estimate of BP lowering effect than labetalol .
Doses higher than the recommended starting dose did not provide additional BP reduction .
Higher doses of dual receptor blockers caused more bradycardia than lower doses .
Based on indirect comparison with other classes of drugs , the blood pressure lowering effect of dual alpha- and beta-receptor blockers is less than non-selective , beta1 selective and partial agonist beta blockers , as well as thiazides and drugs inhibiting the renin angiotensin system .
Dual blockers also had little or no effect on reducing pulse pressure , which is similar to the other beta-blocker classes , but less than the average reduction of pulse pressure seen with thiazides and drugs inhibiting the renin angiotensin system .
Patients taking dual receptor blockers  were not more likely to withdraw from the study compared to patients taking placebo
BACKGROUND Drugs with combined alpha and beta blocking activity are commonly prescribed to treat hypertension .
However , the blood pressure ( BP ) lowering efficacy of this class of beta blockers has not been systematic ally review ed and quantified .
OBJECTIVES To quantify the dose-related effects of various types of dual alpha and beta adrenergic receptor blockers ( dual receptor blockers ) on systolic and diastolic blood pressure versus placebo in patients with primary hypertension .