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Clinical efficacy of carvedilol in severe hypertension
T Ogihara1, K Yoshinaga, Y Kamahara
1Department of Geriatric Medicine, Osaka University Medical School, Japan.
Insights
Carvedilol effectively lowers blood pressure in patients with severe hypertension inadequately controlled by diuretics. This study shows carvedilol, at 10-20 mg daily, is a safe and effective antihypertensive treatment.
Area of Science:
- Cardiology
- Pharmacology
Background:
- Severe hypertension often requires combination therapy for adequate control.
- Diuretic therapy alone may be insufficient for some hypertensive patients.
Purpose of the Study:
- To evaluate the efficacy and safety of carvedilol in severely hypertensive patients inadequately controlled by diuretics.
- To determine optimal dosing of carvedilol in this patient population.
Main Methods:
- Open clinical study involving 26 severely hypertensive patients.
- Initial diuretic treatment followed by incremental doses of carvedilol (5 mg, 10 mg, 20 mg) once daily.
- Blood pressure and heart rate monitored to assess antihypertensive activity and safety.
Main Results:
- Carvedilol (10-20 mg daily) significantly reduced diastolic and systolic blood pressure (p < 0.001).
- An 80% overall antihypertensive effect was observed.
- Heart rate decreased significantly without causing bradycardia.
Conclusions:
- Carvedilol, at doses of 10-20 mg once daily combined with a diuretic, is an effective and safe treatment for severe hypertension.
- This regimen offers a valuable therapeutic option for patients with resistant hypertension.
Abstract:
In an open clinical study, the efficacy and safety of carvedilol was investigated in 26 severely hypertensive patients controlled inadequately on a diuretic [diastolic blood pressure (DBP) greater than 120 mm Hg at first visit and greater than 110 mm Hg following more than 1 week administration of a diuretic]. Following diuretic treatment all patients were initially administered 5 mg of carvedilol once daily. The dose was gradually increased to 10 mg and 20 mg until DBP was reduced below 100 mm Hg or until it was reduced by at least 10 mm Hg. Antihypertensive activity of carvedilol (5 mg) was sufficient in only three cases, but after 4 weeks (inpatients) or 8 weeks (outpatients) administration of carvedilol (10 mg or 20 mg), DBP/systolic blood pressure was significantly reduced from 176 +/- 6/117 +/- 3 to 145 +/- 3/94 +/- 2 mm Hg (p less than 0.001) in all patients. Overall, a sufficient antihypertensive effect was observed in 80% of the patients. Heart rate was significantly decreased from 76 +/- 2 to 67 +/- 2 beats/min, but no patient experienced bradycardia. Carvedilol was generally well tolerated. These findings suggest that 10-20 mg of carvedilol once daily, in combination with a diuretic, is an effective and safe treatment for patients with severe hypertension.