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Resting and postexercise hemodynamic effects of carvedilol, a beta-adrenergic blocker and precapillary vasodilator in
G Leonetti1, L Sampieri, C Cuspidi
1Istituto di Clinica Medica Generale e Terapia Medica, Università di Milano, Italy.
Insights
Carvedilol effectively lowers blood pressure and heart rate in hypertensive patients. This antihypertensive drug also reduces exercise-induced systolic blood pressure increases, demonstrating its dual action.
Area of Science:
- Pharmacology
- Cardiovascular Medicine
Background:
- Carvedilol is a novel antihypertensive medication.
- It possesses both beta-adrenoceptor blocking and vasodilating properties.
Purpose of the Study:
- To evaluate the effects of carvedilol on blood pressure, heart rate, and plasma noradrenaline.
- Assess these effects at rest and during exercise after acute and 7-day oral administration.
Main Methods:
- 12 patients with essential hypertension received carvedilol (25 mg b.i.d.) or placebo.
- Measurements included blood pressure, heart rate, and plasma noradrenaline at rest and during exercise.
Main Results:
- Carvedilol significantly reduced supine and upright blood pressure after acute and 7-day treatment.
- Heart rate was significantly lowered, and the exercise-induced rise in systolic blood pressure was reduced.
- Plasma noradrenaline showed a greater increase during exercise after 7 days of carvedilol treatment.
Conclusions:
- Carvedilol effectively lowers blood pressure and heart rate in hypertensive patients.
- The drug mitigates exercise-induced systolic hypertension, supporting its combined pharmacological actions.
Abstract:
Carvedilol is a recently developed antihypertensive drug that combines in the same molecule a nonselective beta-adrenoceptor blocking effect and a vasodilating precapillary activity. In our study, we have investigated the effects of carvedilol 25 mg b.i.d. on blood pressure, heart rate, and plasma noradrenaline in hypertensive patients at rest and during exercise after acute and repeated oral administration for 7 days. The daily average supine blood pressure of the 12 patients with essential hypertension was 178 +/- 10/107 +/- 3 mm Hg (means +/- SD of 8 measurements in each patient) after placebo and was significantly (p less than 0.01) reduced to 162 +/- 17/99 +/- 8 mm Hg on the first day and to 158 +/- 15/96 +/- 8 mm Hg on the seventh day of carvedilol treatment. Similar values were found in the upright posture. Heart rate was slightly but significantly lowered during acute and repeated administration. The exercise-induced increase in systolic blood pressure was significantly reduced by carvedilol 25 mg b.i.d., while there was a nonsignificant reduction in the tachycardic response. There was a significantly greater rise in plasma noradrenaline during exercise on the seventh day of carvedilol treatment. Carvedilol significantly lowered blood pressure and heart rate at rest and the exercise-induced rise in systolic blood pressure.