Pindolol , celiprolol and alprenolol  lowered SBP and DBP compared to placebo .
Acebutolol  lowered SBP but there was no clear evidence that it lowered DBP .
There was no clear evidence that pindolol and  oxprenolol lowered SBP or DBP .
Higher dose partial agonists did not appear to provide additional BP lowering effects compared to lower dose .
There was no evidence of a greater effect at doses higher than the initial doses .
Based on the indirect comparison of the results in this review and two Cochrane review s on angiotensin-converting-enzyme ( ACE ) inhibitors and angiotensin receptor blockers ( ARBs ) , which also used similar inclusion criteria as this review , the BP lowering effect appeared to be less than the effect in patients with mild to moderate elevated BP who were taking ACE inhibitors  and ARBs based on an indirect comparison .
Withdrawals due to adverse effects were only reported in one trial so it is impossible to assess the harm of these drugs
BACKGROUND Partial agonists are a subclass of beta blockers used to treat hypertension in many countries .
Partial agonist act by stimulating beta receptors when they are quiescent and blocking beta receptors when they are active .
The blood pressure ( BP ) lowering effect of partial agonist beta blockers has not been quantified .
OBJECTIVES To quantify the dose-related effects of various partial agonists beta blockers on systolic blood pressure ( SBP ) , diastolic blood pressure ( DBP ) and heart rate versus placebo in patients with primary hypertension .
Plasma catecholamines following exercise in hypertensives treated with pindolol: comparison with placebo and metoprolol.
This study re-examines the proposal that beta-adrenoceptor blockers with intrinsic sympathomimetic activity decrease plasma noradrenaline levels .  Thirteen patients ( aged 29 - 65 years ) with uncomplicated essential hypertension were r and omly allocated to a three period , double-blind cross-over trial . The treatment periods , each of 3 weeks duration , were composed of placebo , pindolol ( 5 mg twice daily ) and metoprolol ( 100 mg twice daily ) , dispensed in identical capsules . At the end of each treatment period , patients were exercised on a bicycle ergometer to a predetermined workload .  Blood pressure and heart rate were measured before , immediately on completion of exercise and after 10 min post-exercise rest . Blood sample s for plasma noradrenaline and adrenaline determination were also collected at these times . Blood pressures were similar during treatment with pindolol and metoprolol . As expected , heart rate was consistently lower during metoprolol treatment . Basal , pre-exercise plasma noradrenaline and adrenaline were similar at the end of each treatment period . However , the increase following exercise was significantly greater during metoprolol treatment . The post-exercise increase during pindolol treatment was indistinguishable from that in the placebo period . These findings , in a r and omised placebo-controlled study , therefore demonstrate that pindolol does not influence basal or exercise-stimulated plasma noradrenaline and adrenaline concentrations . This is best explained by a lack of effect of pindolol on the plasma clearance of catecholamines , which is impaired by beta-adrenoceptor blockers devoid of intrinsic sympathomimetic activity
Pindolol , celiprolol and alprenolol  lowered SBP and DBP compared to placebo .
Acebutolol  lowered SBP but there was no clear evidence that it lowered DBP .
There was no clear evidence that pindolol and  oxprenolol lowered SBP or DBP .
Higher dose partial agonists did not appear to provide additional BP lowering effects compared to lower dose .
There was no evidence of a greater effect at doses higher than the initial doses .
Based on the indirect comparison of the results in this review and two Cochrane review s on angiotensin-converting-enzyme ( ACE ) inhibitors and angiotensin receptor blockers ( ARBs ) , which also used similar inclusion criteria as this review , the BP lowering effect appeared to be less than the effect in patients with mild to moderate elevated BP who were taking ACE inhibitors  and ARBs based on an indirect comparison .
Withdrawals due to adverse effects were only reported in one trial so it is impossible to assess the harm of these drugs
BACKGROUND Partial agonists are a subclass of beta blockers used to treat hypertension in many countries .
Partial agonist act by stimulating beta receptors when they are quiescent and blocking beta receptors when they are active .
The blood pressure ( BP ) lowering effect of partial agonist beta blockers has not been quantified .
OBJECTIVES To quantify the dose-related effects of various partial agonists beta blockers on systolic blood pressure ( SBP ) , diastolic blood pressure ( DBP ) and heart rate versus placebo in patients with primary hypertension .