Key result
Carvedilol acutely reduced blood pressure by 13/6 mm Hg (25 mg) and 17/10 mm Hg (50 mg) and decreased forearm resistance, with similar blood pressure reductions to propranolol at 4 weeks.
Why the study?
Does carvedilol reduce blood pressure and improve peripheral hemodynamics compared to propranolol in patients with essential hypertension?
RCT (n=30)
Double-blind
randomized
Does carvedilol reduce blood pressure and improve peripheral hemodynamics compared to propranolol in patients with essential hypertension?
Carvedilol provides effective antihypertensive action with a more favorable peripheral hemodynamic profile (vasodilation) compared to propranolol.
Carvedilol enables acute BP reduction plus vasodilation absent with propranolol; extends RCT evidence for dual-action agents in essential hypertension.
Carvedilol (BM14190) is a new compound with combined properties of nonselective beta-adrenoceptor blockade, devoid of ISA, and precapillary vasodilatation. Its acute hemodynamic effects were studied with invasive technique (dye-dilution using Cardio-Green) in 10 patients taking 25 mg orally and noninvasive (fore-arm plethysmography) in 10 patients taking 25 mg and in 10 patients taking 50 mg orally, all with essential hypertension. Significant reductions of systolic and diastolic blood pressures (p less than 0.05 - 0.001) were observed in all groups. TPR did not change acutely whereas resistance in the fore-arm was reduced by 16% (p less than 0.05). When a comparison with propranolol (80 mgx2) was made in a randomized, double-blind placebo controlled trial comprising 30 patients with essential hypertension, carvedilol acutely reduced blood pressure significantly 13/6 mm Hg (25 mg) and 17/10 mm Hg (50 mg) in contrast to propranolol. Resistance in the fore-arm (plethysmography) fell significantly with carvedilol 50 mg whereas propranolol caused a significant rise. After 4 weeks both compounds had reduced blood pressure significantly and to the same extent. Blood flow was still reduced with propranolol in contrast to the findings with carvedilol. We conclude that carvedilol given orally has a useful antihypertensive effect both acutely and during prolonged treatment. It has an attractive hemodynamic profile.
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Eggertsen et al. (1985) conducted an RCT in essential hypertension (n=30). Carvedilol vs. Propranolol (80 mg twice daily) and placebo was evaluated on blood pressure reduction. Carvedilol acutely reduced blood pressure by 13/6 mm Hg (25 mg) and 17/10 mm Hg (50 mg) and decreased forearm resistance, with similar blood pressure reductions to propranolol at 4 weeks.
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