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[Effects of carvedilol on the hemodynamics and its tolerance in elderly patients]
Toshinobu Asai1, Masafumi Kuzuya, Akihiko Koike
1Department of Geriatrics, Nagoya University Graduate School of Medicine.
Insights
Carvedilol, an alpha-beta blocker, safely improved cardiac function and lowered blood pressure in elderly patients with hypertension or angina. This study highlights its potential benefits for older individuals with cardiovascular conditions.
Area of Science:
- Cardiology
- Pharmacology
Background:
- Beta-blockers offer benefits in chronic heart failure but pose side effect risks, leading to physician hesitancy in elderly patients.
- Carvedilol is a non-selective beta-blocker with alpha-1 blocking vasodilating effects, differentiating it from traditional beta-blockers.
Purpose of the Study:
- To evaluate the effects of carvedilol on cardiac parameters in elderly Japanese patients with hypertension, angina pectoris, or both.
- To determine if carvedilol can safely improve left ventricular function in this demographic.
Main Methods:
- A 12-week study involving 16 elderly patients (age ≥ 65) with hypertension, angina, or both.
- Oral administration of carvedilol (10-20 mg daily) followed by echocardiography and hemodynamic parameter calculation.
Main Results:
- Significant reduction in systolic and diastolic blood pressure (p < 0.001/p < 0.01).
- Increase in ejection fraction (p < 0.05) and decrease in heart rate (p < 0.05).
- Carvedilol demonstrated a safe profile in improving cardiac function and blood pressure.
Conclusions:
- Carvedilol effectively and safely improved ejection fraction and decreased blood pressure in elderly patients with hypertension and/or angina.
- Alpha-beta blockers like carvedilol may offer significant benefits for elderly patients when considering individual health conditions.
Abstract:
Clinical trials have shown that beta-blockers can produce symptomatic improvement and decrease the risk of death in chronic heart failure patients. However, the side effects of beta-blockers including worsening heart failure, AV-block, contracting peripheral vessels and unfavorable effects on glucose and cholesterol metabolism tend to make physicians hesitate to prescribe beta-blockers for elderly patients. Carvedilol is a novel non-selective beta-blocker without intrinsic sympathomimetic activity (ISA) and has vasodilating effect through blocking alpha 1 receptor. We examined the effects of carvedilol on cardiac parameters in order to clarify whether beta-blocker may affect left ventricular function in elderly Japanese patients with hypertension, angina pectoris, or both. We examined the hemodynamic effect of carvedilol in 16 patients with hypertension, angina patients or both, aged 65 and over (75.5 +/- 5.6 y.o.). After 12 weeks treatment with 10-20 mg daily oral administration, echocardiography was performed and hemodynamic parameters were calculated to evaluate their cardiac functions. Blood pressure was significantly decreased, especially in systolic pressure (163.8/87.6 +/- 15.6/11.2 mmHg to 141.6/76.9 +/- 16.6/11.7 mmHg, p < 0.001/p < 0.01, respectively). Ejection fraction increase (65.8 +/- 11.8% to 71.2 +/- 11.4%, p < 0.05) accompanied heart rate decrease (72.0 +/- 16.1 bpm to 63.9 +/- 11.4 bpm, p < 0.05). Carvedilol increased ejection fraction and decreased blood pressure safely in elderly patients with hypertension, angina pectoris, or both. Taking the condition of each patient into consideration, alpha-beta-blocker can be beneficial in elder patients.