Metabolic effects of carvedilol in hypertensive patients.
OBJECTIVE
Fifty-six patients with essential hypertension were recruited to study the metabolic effects of carvedilol, a non-selective beta-adrenoceptor-blocker with alpha 1-adrenoceptor blocking properties.


METHODS
The study started with a single-blind, 4-6-week placebo-treatment period followed by an open 6-month active treatment period. There was an option to increase the dose from 25 mg carvedilol to 50 mg daily after 6 weeks. Metabolic investigations were carried out at the end of the placebo period and at the end of the active treatment period.


RESULTS
The results show that during carvedilol treatment blood pressure was efficiently lowered. The increase in very low density lipoprotein triglyceride concentration was 13%. Despite this modest increase high density lipoprotein cholesterol was reduced by 11%. The metabolic clearance rate of glucose at the hyper-insulinemic clamp test (adjusted for the prevailing insulin and glucose concentrations) decreased by 17%. At the i.v. glucose tolerance test the insulin area under the curve was increased by 18% and the glucose area by 10%.


CONCLUSIONS
The alpha 1-adrenoceptor-blocking characteristics of carvedilol probably explain the moderate changes of lipoprotein concentrations and insulin sensitivity gained compared with what is usually obtained with a non-selective beta-adrenoceptor-blocker.
Lithell
H
H
Department of Geriatrics, Uppsala University, Sweden.
Andersson
P E
PE
D000317:Adrenergic alpha-Antagonists / Q000378:metabolism / Q000627:therapeutic use*; D000319:Adrenergic beta-Antagonists / Q000378:metabolism / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D000959:Antihypertensive Agents / Q000378:metabolism / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects; D002227:Carbazoles / Q000378:metabolism / Q000627:therapeutic use*; D000077261:Carvedilol; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D011412:Propanolamines / Q000378:metabolism / Q000627:therapeutic use*; D016037:Single-Blind Method
D000317:Adrenergic alpha-Antagonists; D000319:Adrenergic beta-Antagonists; D000959:Antihypertensive Agents; D002227:Carbazoles; D011412:Propanolamines; D000077261:Carvedilol