Effects of celiprolol on cardiovascular reactivity to laboratory stressors in patients with hypertension.

An ideal antihypertensive drug should reduce blood pressure not only at rest but also during stressful situations. To test whether this criterion is fulfilled by celiprolol, a new beta 1-selective adrenergic blocker drug with peripheral vasodilating activity, we examined the effects of its oral administration on cardiovascular reactivity to laboratory stressors in 18 patients with essential hypertension, according to a placebo-controlled crossover design. In the 12 patients classified as "responders," celiprolol significantly reduced resting systolic and diastolic blood pressure (p less than 0.05 for both). Compared with placebo, celiprolol induced a blood pressure reduction from 179.4 +/- 16.9/119.5 +/- 12.4 mm Hg to 160.7 +/- 12.6/109.4 +/- 3.1 mm Hg during mental arithmetic; from 200.9 +/- 20.7/139.2 +/- 11.9 mm Hg to 184.1 +/- 16.4/127.6 +/- 12.1 mm Hg during handgrip test; from 212.8 +/- 18.5/126.2 +/- 14.2 mm Hg to 185.9 +/- 18.2/117.1 +/- 15.2 mm Hg during cycle ergometry. Our data suggest that in the majority of treated patients celiprolol is effective in reducing blood pressure not only at rest but also during a variety of stressful events, thereby ameliorating the impact of recurring stress-induced increases of blood pressure on the cardiovascular system.