title: Impact of carvedilol on the serum lipid profile.
abstract: OBJECTIVE
  To examine the evidence regarding the impact of carvedilol on the serum lipid profile.
  
  
  METHODS
  Searches in MEDLINE and International Pharmaceutical Abstracts (1966-December 2007) were conducted. Search terms included carvedilol, cholesterol, lipids, hyperlipidemia, and beta-blockers.
  
  
  METHODS
  Published studies and case reports that evaluated the impact of carvedilol on the lipid profile were reviewed. One study was excluded because it evaluated carvedilol for an off-label use and was a small Phase 2 pilot study that evaluated the results of only 10 patients.
  
  
  RESULTS
  Twelve studies were available for review; 6 of these compared carvedilol with beta(1)-selective antagonists. Three studies compared carvedilol with other antihypertensive medications; 2 of those studies evaluated total cholesterol only. Carvedilol alone was evaluated for its effects on lipids in 3 small single-group studies. In 4 of the 12 studies, carvedilol independently improved the lipid profile significantly, while the drug had a nonsignificant, neutral effect on the lipid profile in 3 studies. Furthermore, in 4 of the 12 studies, carvedilol was compared with other antihypertensive medications. In 3 of these 4 studies, the other drugs worsened the lipid profile significantly compared with carvedilol, while carvedilol significantly improved the lipid profile in the other study. Finally, carvedilol had a potentially negative effect on high-density lipoprotein cholesterol in a single-group study, but p values were not reported.
  
  
  CONCLUSIONS
  It is clear that beta(1)-selective antagonists worsen the lipid profile compared with carvedilol. However, it is unclear whether carvedilol independently makes an improvement or has a neutral effect on the lipid profile. Carvedilol should be an important treatment consideration in patients with heart failure and/or hypertension with dyslipidemia. However, many questions remain regarding this issue.
authors: College of Pharmacy, Southwestern Oklahoma State University, Weatherford, OK 73096, USA. randall.sharp@swosu.edu
authors: Randall P
authors: RP
authors: Sharp
authors: Riaz
authors: R
authors: Sirajuddin
authors: Imran M
authors: IM
authors: Sharief
mesh_terms: D000317:Adrenergic alpha-Antagonists / Q000009:adverse effects / Q000627:therapeutic use*; D000319:Adrenergic beta-Antagonists / Q000009:adverse effects / Q000627:therapeutic use*; D002227:Carbazoles / Q000009:adverse effects / Q000627:therapeutic use*; D000077261:Carvedilol; D008076:Cholesterol, HDL / Q000097:blood; D006801:Humans; D008055:Lipids / Q000097:blood*; D011412:Propanolamines / Q000009:adverse effects / Q000627:therapeutic use*; D014280:Triglycerides / Q000097:blood
chemical_list: D000317:Adrenergic alpha-Antagonists; D000319:Adrenergic beta-Antagonists; D002227:Carbazoles; D008076:Cholesterol, HDL; D008055:Lipids; D011412:Propanolamines; D014280:Triglycerides; D000077261:Carvedilol