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Appropriate dose transition to a controlled-release formulation of carvedilol in patients with hypertension

George L Bakris1, Michael A Weber

  • 1Hypertensive Diseases Unit, Section of Endocrinology, Diabetes, and Metabolism, University of Chicago Pritzker School of Medicine, Chicago, Illinois, USA.

Reviews in Cardiovascular Medicine
|July 29, 2008
PubMed

Insights

Most patients with hypertension need multiple medications. Vasodilating beta-blockers like carvedilol offer benefits over other beta-blockers, with once-daily carvedilol potentially being superior for managing high blood pressure.

Area of Science:

  • Cardiology
  • Pharmacology

Background:

  • Hypertension management often requires multiple antihypertensive medications.
  • Beta-blockers are recommended for hypertension, especially with compelling indications.
  • Significant differences exist among beta-blockers regarding pharmacology, hemodynamics, and tolerability.

Purpose of the Study:

  • To highlight the evidence-based selection of beta-blockers for high-risk hypertension.
  • To compare vasodilating beta-blockers with other classes.
  • To evaluate the potential benefits of carvedilol CR.

Main Methods:

  • Review of pharmacologic properties and clinical trial data of beta-blockers.
  • Focus on vasodilating beta-blockers, specifically carvedilol.
  • Comparison of carvedilol CR (once daily) versus twice-daily regimens.

Main Results:

  • Vasodilating beta-blockers, such as carvedilol, effectively lower blood pressure.
  • Carvedilol avoids adverse hemodynamic, renal, and metabolic effects common to other beta-blockers.
  • Once-daily carvedilol CR may offer an improved regimen.

Conclusions:

  • The choice of beta-blocker for high-risk hypertension should be evidence-based, considering pharmacologic differences.
  • Vasodilating beta-blockers represent a favorable option.
  • Carvedilol CR presents a potentially preferable dosing strategy.

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