Four patient profiles in whom it is beneficial to use carvedilol Review article
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Published:
Sep 30, 2018
Keywords:
carvedilol, β-blocker, hypertension, heart failure, metabolic disorders
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Abstract
Carvedilol is a vasodilating non-cardioselective third-generation β-blocker, without adverse hemodynamic and metabolic effects of traditional β-blockers. Compared with conventional β-blockers, carvedilol maintains cardiac output, has a prolonged reducing effect on the heart rate, and reduces arterial blood pressure by decreasing vascular resistance. Studies have also shown that carvedilol exhibits favourable effects on metabolic parameters, e.g. glycaemic control, insulin sensitivity and lipid metabolism, suggesting that it should be considered in the treatment of patients with metabolic syndrome or diabetes.
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How to Cite
Postuła , M. (2018). Four patient profiles in whom it is beneficial to use carvedilol. Medycyna Faktow (J EBM), 9(3(32), 212-216. Retrieved from https://journalsmededu.pl/index.php/jebm/article/view/2221
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References
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2. Sarafidis PA, Bakris GL. Antihypertensive treatment with beta-blockers and the spectrum of glycaemic control. QJM 2006; 99(7): 431-436.
3. Frishman WH. A historical perspective on the development of beta-adrenergic blockers. J Clin Hypertens 2007; 9(4 supl. 3): 19-27.
4. Meyer-Sabellek W, Schulte KL, Distler A, Gotzen R. Circadian antihypertensive profile of carvedilol (BM 14190). J Cardiovasc Pharmacol 1987; 10(supl. 11): S119-S123.
5. Lund-Johansen P, Omvik P, Nordrehaug JE, White W. Carvedilol in hypertension: effects on hemodynamics and 24-hour blood pressure. J Cardiovasc Pharmacol 1992; 19 (supl. 1): S27-S34.
6. van der Does R, Widmann L, Uberbacher HJ et al. Efficacy and safety of carvedilol in comparison with atenolol in hypertensive patients pretreated with hydrochlorothiazide. Eur J Clin Pharmacol 1990; 38(supl. 2): S147-S152.
7. Hall S, Prescott RI, Hallman RJ et al. A comparative study of carvedilol, slow-release nifedipine, and atenolol in the management of essential hypertension. J Cardiovasc Pharmacol 1991; 18(supl. 4): S35-S38.
8. Moser M, Frishman W. Results of therapy with carvedilol, a beta-blocker vasodilator with antioxidant properties, in hypertensive patients. Am J Hypertens 1998; 11(1 Pt 2): 15S-22S.
9. Verma U, Bano G, Mohan Lal B et al. Antihypertensive efficacy of carvedilol and amlodipine in patients of mild to moderate hypertension – a comparative study. JK Science 2004; 6(4): 193-196.
10. Erdoğan O, Ertem B, Altun A. Comparison of antihypertensive efficacy of carvedilol and nebivolol in mild-to-moderate primary hypertension: a randomised trial. Anadolu Kardiyol Derg 2011; 11(4): 310-313.
11. Messerli FH, Grossman E. Beta-blockers in hypertension: is carvedilol different? Am J Cardiol 2004; 93 supl.: 7B-12B.
12. Aronow WS. Current role of beta-blockers in the treatment of hypertension. Expert Opin Pharmacother 2010; 11(16): 2599-2607.
13. Kasiske BL, Ma JZ, Kalil RS et al. Effects of antihypertensive therapy on serum lipids. Ann Intern Med 1995; 122(2): 133-141.
14. Brook RD. Mechanism of differential effects of antihypertensive agents on serum lipids. Curr Hypertens Rep 2000; 2(4): 370-377.
15. Maitland-van der Zee AH, Klungel OH, Kloosterman JM et al. The association between antihypertensive drug therapies and plasma lipid levels in the general population. J Hum Hypertens 2001; 15(10): 701-705.
16. Giugliano D, Acampora R, Marfella R et al. Metabolic and cardiovascular effects of carvedilol and atenolol in non-insulin-dependent diabetes mellitus and hypertension. A randomised, controlled trial. Ann Intern Med 1997; 126(12): 955-959.
17. Messerli FH, Bell DS, Fonseca V et al; GEMINI Investigators: Body weight changes with beta-blocker use: results from GEMINI. Am J Med 2007; 120(7): 610-615.
18. Bakris GL, Fonseca V, Katholi RE et al; GEMINI Investigators: Metabolic effects of carvedilol vs. metoprolol in patients with type 2 diabetes mellitus and hypertension: a randomised controlled trial. JAMA 2004; 292(18): 2227-2236.
19. Fonarow GC, Deedwania P, Fonseca V et al. Differential effects of extended-release carvedilol and extended-release metoprolol on lipid profiles in patients with hypertension: results of the Extended-Release Carvedilol Lipid Trial. J Am Soc Hypertens 2009; 3(3): 210-220.
20. Haenni A, Lithell H. Treatment with a beta-blocker with beta 2-agonism improves glucose and lipid metabolism in essential hypertension. Metabolism 1994; 43(4): 455-461.
21. Malminiemi K. Association between serum lipids, glucose tolerance, and insulin sensitivity during 12 months of celiprolol treatment. Cardiovasc Drugs Ther 1995; 9(2): 295-304.
22. Poole-Wilson PA, Swedberg K, Cleland JG et al; Carvedilol or Metoprolol European Trial Investigators: Comparison of carvedilol and metoprolol on clinical outcomes in patients with chronic heart failure in the Carvedilol or Metoprolol European Trial (COMET): randomised controlled trial. Lancet 2003; 362(9377): 7-13.
23. Ozyıldız AG, Eroglu S, Bal U et al. Effects of Carvedilol Compared to Nebivolol on Insulin Resistance and Lipid Profile in Patients With Essential Hypertension. J Cardiovasc Pharmacol Ther 2016 Apr 18 [pii: 1074248416644987] [Epub ahead of print].
24. Carella AM, Antonucci G, Conte M et al. Antihypertensive treatment with beta-blockers in the metabolic syndrome: a review. Curr Diabetes Rev 2010; 6(4): 215-221.
25. Uzunlulu M, Oguz A, Yorulmaz E. The effect of carvedilol on metabolic parameters in patients with metabolic syndrome. Int Heart J 2006; 47(3): 421-430.
26. Packer M, Antonopoulos GV, Berlin JA et al. Comparative effects of carvedilol and metoprolol on left ventricular ejection fraction in heart failure: results of a meta-analysis. Am Heart J 2001; 141: 899-907.
27. Jabbour A, Macdonald PS, Keogh AM et al. Differences between beta-blockers in patients with chronic heart failure and chronic obstructive pulmonary disease: a randomised crossover trial. J Am Coll Cardiol 2010; 55: 1780-1787.
28. Shen X, Nair CK, Aronow WS et al. Effect of carvedilol versus metoprolol CR/XL on mortality in patients with heart failure treated with cardiac resynchronization therapy: a COX multivariate regression analysis. Am J Ther 2013; 20: 247-253.
29. Ruwald MH, Ruwald AC, Jons C et al. Effect of metoprolol versus carvedilol on outcomes in MADIT-CRT (multicenter automatic defibrillator implantation trial with cardiac resynchronization therapy). J Am Coll Cardiol 2013; 61: 1518-1526.
30. Packer M, Fowler MB, Roecker EB et al. Effect of carvedilol on the morbidity of patients with severe chronic heart failure: results of the Carvedilol Prospective Randomised Cumulative Survival (COPERNICUS) study. Circulation 2002; 106: 2194-2199.
31. Eichhorn EJ, Bristow MR. The Carvedilol Prospective Randomised Cumulative Survival (COPERNICUS) trial. Curr Control Trials Cardiovasc Med 2001; 2(1): 20-23.
32. Packer M, Bristow MR, Cohn JN et al; for the US Carvedilol Heart Failure Study Group: The effect of carvedilol on morbidity and mortality in patients with chronic heart failure. N Engl J Med 1996; 334: 1349-1355.
33. Chatterjee S, Biondi-Zoccai G, Abbate A et al. Benefits of β blockers in patients with heart failure and reduced ejection fraction: network meta- analysis. BMJ 2013; 346: f55.
34. DiNicolantonio JJ, Lavie CJ, Fares H et al. Meta-analysis of carvedilol versus beta 1 selective beta-blockers (atenolol, bisoprolol, metoprolol, and nebivolol). Am J Cardiol 2013; 111(5): 765-769.
35. Dargie HJ. Effect of carvedilol on outcome after myocardial infarction in patients with left-ventricular dysfunction: the CAPRICORN randomised trial. Lancet 2001; 357: 1385-1390.
36. Jonsson G, Abdelnoor M, Muller C et al. A comparison of the two B-blockers carvedilol and atenolol on left ventricular ejection fraction and clinical endpoints after myocardial infarction: a single-centre, randomised study of 232 patients. Cardiology 2005; 103: 148-155.
2. Sarafidis PA, Bakris GL. Antihypertensive treatment with beta-blockers and the spectrum of glycaemic control. QJM 2006; 99(7): 431-436.
3. Frishman WH. A historical perspective on the development of beta-adrenergic blockers. J Clin Hypertens 2007; 9(4 supl. 3): 19-27.
4. Meyer-Sabellek W, Schulte KL, Distler A, Gotzen R. Circadian antihypertensive profile of carvedilol (BM 14190). J Cardiovasc Pharmacol 1987; 10(supl. 11): S119-S123.
5. Lund-Johansen P, Omvik P, Nordrehaug JE, White W. Carvedilol in hypertension: effects on hemodynamics and 24-hour blood pressure. J Cardiovasc Pharmacol 1992; 19 (supl. 1): S27-S34.
6. van der Does R, Widmann L, Uberbacher HJ et al. Efficacy and safety of carvedilol in comparison with atenolol in hypertensive patients pretreated with hydrochlorothiazide. Eur J Clin Pharmacol 1990; 38(supl. 2): S147-S152.
7. Hall S, Prescott RI, Hallman RJ et al. A comparative study of carvedilol, slow-release nifedipine, and atenolol in the management of essential hypertension. J Cardiovasc Pharmacol 1991; 18(supl. 4): S35-S38.
8. Moser M, Frishman W. Results of therapy with carvedilol, a beta-blocker vasodilator with antioxidant properties, in hypertensive patients. Am J Hypertens 1998; 11(1 Pt 2): 15S-22S.
9. Verma U, Bano G, Mohan Lal B et al. Antihypertensive efficacy of carvedilol and amlodipine in patients of mild to moderate hypertension – a comparative study. JK Science 2004; 6(4): 193-196.
10. Erdoğan O, Ertem B, Altun A. Comparison of antihypertensive efficacy of carvedilol and nebivolol in mild-to-moderate primary hypertension: a randomised trial. Anadolu Kardiyol Derg 2011; 11(4): 310-313.
11. Messerli FH, Grossman E. Beta-blockers in hypertension: is carvedilol different? Am J Cardiol 2004; 93 supl.: 7B-12B.
12. Aronow WS. Current role of beta-blockers in the treatment of hypertension. Expert Opin Pharmacother 2010; 11(16): 2599-2607.
13. Kasiske BL, Ma JZ, Kalil RS et al. Effects of antihypertensive therapy on serum lipids. Ann Intern Med 1995; 122(2): 133-141.
14. Brook RD. Mechanism of differential effects of antihypertensive agents on serum lipids. Curr Hypertens Rep 2000; 2(4): 370-377.
15. Maitland-van der Zee AH, Klungel OH, Kloosterman JM et al. The association between antihypertensive drug therapies and plasma lipid levels in the general population. J Hum Hypertens 2001; 15(10): 701-705.
16. Giugliano D, Acampora R, Marfella R et al. Metabolic and cardiovascular effects of carvedilol and atenolol in non-insulin-dependent diabetes mellitus and hypertension. A randomised, controlled trial. Ann Intern Med 1997; 126(12): 955-959.
17. Messerli FH, Bell DS, Fonseca V et al; GEMINI Investigators: Body weight changes with beta-blocker use: results from GEMINI. Am J Med 2007; 120(7): 610-615.
18. Bakris GL, Fonseca V, Katholi RE et al; GEMINI Investigators: Metabolic effects of carvedilol vs. metoprolol in patients with type 2 diabetes mellitus and hypertension: a randomised controlled trial. JAMA 2004; 292(18): 2227-2236.
19. Fonarow GC, Deedwania P, Fonseca V et al. Differential effects of extended-release carvedilol and extended-release metoprolol on lipid profiles in patients with hypertension: results of the Extended-Release Carvedilol Lipid Trial. J Am Soc Hypertens 2009; 3(3): 210-220.
20. Haenni A, Lithell H. Treatment with a beta-blocker with beta 2-agonism improves glucose and lipid metabolism in essential hypertension. Metabolism 1994; 43(4): 455-461.
21. Malminiemi K. Association between serum lipids, glucose tolerance, and insulin sensitivity during 12 months of celiprolol treatment. Cardiovasc Drugs Ther 1995; 9(2): 295-304.
22. Poole-Wilson PA, Swedberg K, Cleland JG et al; Carvedilol or Metoprolol European Trial Investigators: Comparison of carvedilol and metoprolol on clinical outcomes in patients with chronic heart failure in the Carvedilol or Metoprolol European Trial (COMET): randomised controlled trial. Lancet 2003; 362(9377): 7-13.
23. Ozyıldız AG, Eroglu S, Bal U et al. Effects of Carvedilol Compared to Nebivolol on Insulin Resistance and Lipid Profile in Patients With Essential Hypertension. J Cardiovasc Pharmacol Ther 2016 Apr 18 [pii: 1074248416644987] [Epub ahead of print].
24. Carella AM, Antonucci G, Conte M et al. Antihypertensive treatment with beta-blockers in the metabolic syndrome: a review. Curr Diabetes Rev 2010; 6(4): 215-221.
25. Uzunlulu M, Oguz A, Yorulmaz E. The effect of carvedilol on metabolic parameters in patients with metabolic syndrome. Int Heart J 2006; 47(3): 421-430.
26. Packer M, Antonopoulos GV, Berlin JA et al. Comparative effects of carvedilol and metoprolol on left ventricular ejection fraction in heart failure: results of a meta-analysis. Am Heart J 2001; 141: 899-907.
27. Jabbour A, Macdonald PS, Keogh AM et al. Differences between beta-blockers in patients with chronic heart failure and chronic obstructive pulmonary disease: a randomised crossover trial. J Am Coll Cardiol 2010; 55: 1780-1787.
28. Shen X, Nair CK, Aronow WS et al. Effect of carvedilol versus metoprolol CR/XL on mortality in patients with heart failure treated with cardiac resynchronization therapy: a COX multivariate regression analysis. Am J Ther 2013; 20: 247-253.
29. Ruwald MH, Ruwald AC, Jons C et al. Effect of metoprolol versus carvedilol on outcomes in MADIT-CRT (multicenter automatic defibrillator implantation trial with cardiac resynchronization therapy). J Am Coll Cardiol 2013; 61: 1518-1526.
30. Packer M, Fowler MB, Roecker EB et al. Effect of carvedilol on the morbidity of patients with severe chronic heart failure: results of the Carvedilol Prospective Randomised Cumulative Survival (COPERNICUS) study. Circulation 2002; 106: 2194-2199.
31. Eichhorn EJ, Bristow MR. The Carvedilol Prospective Randomised Cumulative Survival (COPERNICUS) trial. Curr Control Trials Cardiovasc Med 2001; 2(1): 20-23.
32. Packer M, Bristow MR, Cohn JN et al; for the US Carvedilol Heart Failure Study Group: The effect of carvedilol on morbidity and mortality in patients with chronic heart failure. N Engl J Med 1996; 334: 1349-1355.
33. Chatterjee S, Biondi-Zoccai G, Abbate A et al. Benefits of β blockers in patients with heart failure and reduced ejection fraction: network meta- analysis. BMJ 2013; 346: f55.
34. DiNicolantonio JJ, Lavie CJ, Fares H et al. Meta-analysis of carvedilol versus beta 1 selective beta-blockers (atenolol, bisoprolol, metoprolol, and nebivolol). Am J Cardiol 2013; 111(5): 765-769.
35. Dargie HJ. Effect of carvedilol on outcome after myocardial infarction in patients with left-ventricular dysfunction: the CAPRICORN randomised trial. Lancet 2001; 357: 1385-1390.
36. Jonsson G, Abdelnoor M, Muller C et al. A comparison of the two B-blockers carvedilol and atenolol on left ventricular ejection fraction and clinical endpoints after myocardial infarction: a single-centre, randomised study of 232 patients. Cardiology 2005; 103: 148-155.