Effect of carvedilol on left ventricular function and mass in hypertension

The effects of carvedilol, a nonselective beta-blocker with peripheral vasodilator action, on left ventricular function and mass in essential hypertension were studied in 14 patients with diastolic filling abnormalities. Treatment produced significant decreases in blood pressure (systolic: 168.4 +/- 10.5 to 154 +/- 17.2 mm Hg, p less than 0.005; diastolic: 101.6 +/- 8.6 to 95.3 +/- 11.6 mm Hg, p less than 0.025), left ventricular mass (316.7 +/- 85.8 to 276.8 +/- 84.9 g, p less than 0.05), and left ventricular mass index (157.9 +/- 42.4 to 131.6 +/- 34.6 g.m-2, p less than 0.025). There were coincident improvements in the parameters of diastolic left ventricular filling (E/A ratio: 0.66 +/- 0.14 to 0.80 +/- 0.26, p less than 0.025; mean E descent velocity: 245 +/- 130 to 264 +/- 70 cm.s-2, p less than 0.05). No significant alterations in systolic function were observed, although three patients with systolic impairment improved to normal during treatment. Two other patients, however, were withdrawn from the study because of hypotension and cardiac failure. In conclusion, carvedilol is effective in the treatment of hypertension and produces adequate blood pressure control with a percentage reduction in left ventricular mass. The associated changes in diastolic function may be due in part to the mass reduction, but no direct relation has been established, and the effect of afterload reduction on diastolic left ventricular filling remains important.