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 .
A multi-centre, placebo controlled comparative study between 200 mg and 400 mg celiprolol in patients with mild to moderate essential hypertension.
A two-centre , double-blind , placebo controlled , r and omized 3-way crossover study was undertaken to assess the efficacy , tolerability and safety of celiprolol in mild to moderate essential hypertension . A 4-week single-blind placebo run-in/screening period , during which no antihypertensive medication was given , was followed by 3 consecutive 4-week treatment periods with placebo or celiprolol ( 200 mg or 400 mg daily ) . At the end of the 4-week placebo run-in/screening period , 26 hospital out- patients with a seated mean blood pressure ( systolic/diastolic ) of 161.4/101.7 mmHg and a mean pulse rate of 75 beats/min entered the double-blind crossover phase of the study . Results showed that there was no significant difference in seated mean systolic or diastolic blood pressure between 200 mg celiprolol daily ( 149.2/92.3 mmHg ) and 400 mg celiprolol daily ( 149.1/92.5 mmHg ) . However , mean seated systolic and diastolic blood pressures were significantly ( p less than 0.05 ) lower on celiprolol than on placebo ( 157.1/98.2 mmHg ) . Neither dose of celiprolol had a significant effect on seated pulse rate . No patient was withdrawn due to an adverse event and no laboratory assessment outside the normal range was reported to be of any clinical significance . It is concluded that oral celiprolol , 200 mg or 400 mg daily , is effective and well tolerated for controlling mild to moderate essential hypertension . Since both doses had very similar effects on blood pressure there is no advantage in this group of patients for the 400 mg daily dose of celiprolol
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 .