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 .
Double-blind factorial trial of prindolol and hydrochlorothiazide in hypertension.
The antihypertensive actions of the beta-adrenergic blocking agent , prindolol , and of the diuretic , hydrochlorothiazide , were analysed in a double-blind r and omized 2 X 2 factorial trial in 16 patients . There were four eight-week phases in which patients received prindolol alone , hydrochlorothiazide alone , prindolol plus hydrochlorothiazide in combination , and no treatment . Both drugs were given in fixed doses : prindolol , 10 mg three times per day ; hydrochlorothiazide , 50 mg per day . Blood pressure was measured weekly , alternately at the outpatient clinic and at home . Supine mean arterial pressure ( MAP ) in resting patients fell from 127 mm Hg in the placebo phase to 117 mm Hg with hydrochlorothiazide alone , 116 mm Hg with prindolol alone , and 111 mm Hg with the combination of prindolol and hydrochlorothiazide . ( The st and ard error of difference between treatments was + /-3 - 58 ) . A mean factorial effect of -7 mm Hg for hydrochlorothiazide ( P less than 0 - 01 ) and -8 mm Hg for prindolol ( P less than 0 - 01 ) was obtained , and the two drugs acted in an additive manner . The effects on st and ing blood pressure in resting patients were similar . No serious side effects were noted
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 .