Carvedilol in the Treatment of Hypertension - A Review of the Clinical Data Base

Carvedilol is a novel antihypertensive agent. It is a multiple-action neurohormonal antagonist with a beta-adrenoceptor blocking effect combined with a vasodilating action based on alpha1-adrenoceptor blockade. In addition, carvedilol exerts a number of well documented ancillary effects such as being a scavenger of free radicals. It also has an antiproliferative action on smooth muscle cells. This combination of effects opens up a number of interesting clinical perspectives. It is the purpose of this brief review to summarize some of the clinical studies that have been performed with carvedilol. Investigations in hypertensive patients will form the basis of this review, but special interest will also be devoted to other patient groups. In particular the therapeutic value of carvedilol will be discussed in patients with concomitant disorders such as atheromatosis, left ventricular hypertrophy, angina pectoris, myocardial infarction, congestive heart failure, arrhythmias, stroke, renal failure or diabetes. Finally, the usefulness of carvedilol in the treatment of elderly hypertensive patients will be reviewed. It is evident from the available scientific literature that carvedilol is an antihypertensive agent with a novel mode of action. It is effective in many of the subpopulations of patients alluded to above. It appears reasonable to assume that some of these therapeutic effects can be attributed to its ancillary properties.