A comparison of carvedilol with atenolol in the treatment of mild-to-moderate essential hypertension. INT-CAR-07 (U.K.) Study Group.
The efficacy and safety of carvedilol, a beta-blocker with vasodilating properties, were compared at a dosage of 25 to 50 mg once daily with those of atenolol at a dosage of 50-100 mg once daily in a double-blind, randomized, parallel-group, multicenter study. After a single-blind placebo phase of 3 to 6 weeks, 47 patients (median age, 59 years) were randomized to receive carvedilol and 52 patients (median age, 57 years) were randomized to receive atenolol for an 8-week study period. Patients on carvedilol received 12.5 mg for the first 2 days and then 25 mg as a once-daily dosage. The initial dosage of atenolol was 50 mg once daily. The dosage of each treatment could be doubled (to 50 and 100 mg once daily, respectively) at week 4 if the response was inadequate. Sitting and standing blood pressures and heart rates were recorded 24 h after the dose at weeks 4 and 8. Data from 90 of 98 patients who completed the study were eligible for per-protocol analysis. Approximately one-third of the patients in each group required upward dose titration at week 4 because of inadequate response. At week 8, 84% patients receiving carvedilol and 91% receiving atenolol had sitting diastolic blood pressure less than or equal to 90 mm Hg or decreased their blood pressure by greater than or equal to 10 mm Hg (95% confidence intervals for difference between carvedilol and atenolol, +7% and -21%). Safety profiles were similar between treatments. One patient withdrew; a skin rash developed during the fourth week of treatment with atenolol.(ABSTRACT TRUNCATED AT 250 WORDS)
Young
P H
PH
Clinical Research Manager, Research and Development Pharmaceuticals, UK.
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001262:Atenolol / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects*; D002227:Carbazoles / Q000627:therapeutic use*; D000077261:Carvedilol; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D011412:Propanolamines / Q000627:therapeutic use*; D014665:Vasodilator Agents / Q000627:therapeutic use*
D000319:Adrenergic beta-Antagonists; D000959:Antihypertensive Agents; D002227:Carbazoles; D011412:Propanolamines; D014665:Vasodilator Agents; D000077261:Carvedilol; D001262:Atenolol