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 .
BOPINDOLOL IN THE TREATMENT OF MODERATE HYPERTENSION: A DOSE‐RESPONSE STUDY
Summary — To determine the optimal antihypertensive dose of bopindolol , we performed a r and omized double‐blind study in parallel groups . After 15 days of placebo single‐blind , 115 hypertensive patients received daily for 28 days one of 4 doses : 0 mg ( placebo ) , 0.5 mg , 1.0 mg , 2.0 mg . The reduction of supine diastolic blood pressure ( BP ) did not exhibit the pattern of a dose‐effect relationship . The effect of 0.5 mg belonged to the plateau of the dose‐effect curve ( P=0.1 , analysis of variance ) . The reduction of heart rate ( HR ) followed a typical dose‐effect curve , with a plateau beginning with 1 mg ( P = 0.02 ) . A trend toward an increase in the incidence of side‐effects with dosage was observed ( P=0.3 ) . Thus , the optimal antihypertensive dose may be 0.5 mg or less . Previous studies not using parallel r and omized groups suggested an antihypertensive dose ranging from 2 to 4 mg . This study confirms that the dose‐effect curves of beta blockers on HR and BP are dissociated . The dose‐effect curve of HR seems unsuitable for assessing the optimal antihypertensive dose of a beta blocker
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 .