Acute hemodynamic effects of the vasodilating and beta-blocking agent carvedilol in comparison to propranolol.
In a randomized double-blind study, oral doses of 50 mg carvedilol were compared to 40 mg propranolol in 16 male patients with coronary heart disease (12 without significant stenosis after percutaneous transluminal coronary angioplasty) at rest, during and after exercise, and before and 80 min after drug application. Systemic and pulmonary pressures, heart rate, cardiac index, and lower limb blood flow were measured, and systemic and pulmonary resistances calculated. Carvedilol does not lead, as the classical beta-blocker propranolol does, to an increase in systemic or pulmonary resistance, nor to a decrease in cardiac output, or to an increase of the pulmonary capillary wedge pressure during exercise. In contrast to propranolol, the postexercise lower limb blood flow has increased significantly. The differences in action between the two beta-blockers can be explained by the vasodilating properties of carvedilol. Due to these acute effects, carvedilol may be of advantage compared to propranolol in the treatment of peripheral occlusive artery disease, hypertension, and coronary vasospasm.
Wendt
T
T
University Clinic, Department of Cardiology, Frankfurt, F.R.G.
van der Does
R
R
Schräder
R
R
Landgraf
H
H
Kober
G
G
D000319:Adrenergic beta-Antagonists / Q000494:pharmacology* / Q000627:therapeutic use; D000328:Adult; D001794:Blood Pressure / Q000187:drug effects; D002227:Carbazoles / Q000494:pharmacology* / Q000627:therapeutic use; D000077261:Carvedilol; D003327:Coronary Disease / Q000188:drug therapy* / Q000503:physiopathology; D004311:Double-Blind Method; D006339:Heart Rate / Q000187:drug effects; D006439:Hemodynamics / Q000187:drug effects*; D006801:Humans; D007866:Leg / Q000098:blood supply; D008297:Male; D008875:Middle Aged; D005082:Physical Exertion; D011412:Propanolamines / Q000494:pharmacology* / Q000627:therapeutic use; D011433:Propranolol / Q000494:pharmacology* / Q000627:therapeutic use; D011669:Pulmonary Wedge Pressure / Q000187:drug effects; D011897:Random Allocation; D014655:Vascular Resistance / Q000187:drug effects
D000319:Adrenergic beta-Antagonists; D002227:Carbazoles; D011412:Propanolamines; D000077261:Carvedilol; D011433:Propranolol