Safety and efficacy of once-daily carvedilol vs twice-daily labetalol in mild to moderate hypertension.
A multicenter, randomized, double-blind, parallel-group trial of 8 weeks' duration was designed to compare the efficacy and safety of once-daily carvedilol with that of twice-daily labetalol in patients with essential hypertension. A total of 61 patients (13 women and 48 men) aged 26-64 years (mean +/- SEM = 49.6 +/- 1.3 years) were enrolled. All patients had mild to moderate hypertension, defined as diastolic blood pressure (DBP) of 95-114 mm Hg at the end of a 1- to 2-week single-blind placebo period. In all, 30 patients received carvedilol (25 mg once daily) and 31 received labetalol (200 mg twice daily). The initial dose could be doubled for both treatment groups at day 29 if the DBP was greater than 90 mmHg on days 28 and 29. Hemodynamic parameters, including supine and standing DBP, systolic blood pressure (SBP), and heart rate (HR), were measured and safety was evaluated at baseline and at days 14, 28, and 56 at the end of the dosing interval. In all, 3 patients on carvedilol and 4 patients on labetalol required upward dose titration after 1 month. At the end of the trial, 26 of 30 carvedilol-treated patients and 27 of 31 labetalol-treated patients (87% of each group) had a supine DBP of less than or equal to 90 mm Hg. On day 56, mean decreases in supine DBP, SBP, and HR in the carvedilol group were 18.5 and 23.4 mm Hg and 11 beats/min, respectively, from baseline values of 101.6 and 163.8 mm Hg and 80 beats/min, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)
Ollivier
J P
JP
Hôpital du Val de Grâce, Paris, France.
Durier
P
P
Bussiere
J L
JL
Gayet
J L
JL
D000319:Adrenergic beta-Antagonists / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects; D002227:Carbazoles / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D000077261:Carvedilol; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000503:physiopathology; D007741:Labetalol / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D015337:Multicenter Studies as Topic; D011412:Propanolamines / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic
D000319:Adrenergic beta-Antagonists; D002227:Carbazoles; D011412:Propanolamines; D000077261:Carvedilol; D007741:Labetalol