Carvedilol is a beta blocker approved by the Food Drug and Administration to treat hypertension, among other heart conditions.1,2 Although beta blockers are not recommended as a first-line therapy for adults with hypertension according to the 2017 American College of Cardiology and American Heart Association hypertension guidelines,3 studies on hypertensive patients show that carvedilol treatment can be effective in reducing blood pressure.4-9
A meta-analysis of 36 clinical studies on 3,412 patients with mild to moderate essential hypertension concluded that carvedilol is effective in reducing blood pressure.4,5 The review found that two to four weeks of daily administration of a 25 mg or 50 mg dose of carvedilol significantly decreased mean systolic and diastolic blood pressure.5 For the group that received the 25 mg dose of carvedilol, blood pressure was reduced by 15.5/11.2 mm Hg from a baseline value of 165.6/102.7 mm Hg (p<0.001). The group that received the 50 mg dose experienced a 17.9/13.0 mm Hg from a baseline value of 166.5/104.8 mm Hg (p<0.001).
Many clinical trials have shown that carvedilol treatment is effective in lowering systolic and diastolic blood pressure in patients with hypertension.6-9 A randomized, controlled trial studying 20 patients with mild to moderate hypertension found that a month of carvedilol treatment was effective in reducing systolic and diastolic blood pressure.6 Baseline blood pressure of 141 ± 7.5/92.4 ± 7.7 mm Hg dropped to 133.8 ± 9/86.6 ± 8.6 mm Hg with the 25 mg carvedilol treatment. This was significantly lower than the blood pressure of patients after they received the placebo treatment (143.9 ± 8.9/94.4 ± 9.2 mm Hg, p<0.05).
Another randomized, double-blinded, placebo-controlled trial studied the effect of 50 mg of carvedilol on 20 patients with mild to moderate essential hypertension.7 Mean blood pressure decreased from 126 ± 2.7 mm Hg before the treatment to 105.4 ± 5 (p<0.01) at two hours after carvedilol administration. When patients were given chronic treatment for four weeks, mean blood pressure also significantly decreased, from 126 ± 2.7 mm Hg before to 111.5 ± 4.2 mm Hg (p<0.01). Systolic and diastolic blood pressures significantly decreased by 13.7% and 13%, respectively. The placebo group’s blood pressure remained unchanged after acute and chronic treatment. Another randomized, double-blinded study of 118 patients with mild to moderate essential hypertension found that median blood pressure decreased from 167/105 mm Hg at baseline to 155/94 mm Hg after four weeks on a daily dose of 25 mg carvedilol (p<0.001).9
A randomized, controlled trial of 656 hypertensive patients assessed carvedilol or lisinopril monotherapy in varying doses and combined therapy of the two agents at different doses.8 The study found that carvedilol monotherapy was effective in reducing blood pressure. A 20 mg/day dose of carvedilol monotherapy reduced 24-hour mean systolic and diastolic blood pressure by 7.7 ± 2.4 mm Hg and 1.7 ± 2.8 mm Hg from a mean baseline value of 149 ± 9.3 mm Hg and 94.4 ± 5.4 mm Hg, respectively. Similar results were found for carvedilol at the 40 mg/day and 80 mg/day treatment. The 40 mg/day group had a decrease of 9.8 ± 2.0/7.7 ± 2.4 mm Hg from 146.8 ± 10.6/93.4 ± 6.4 mm Hg at baseline. The 80 mg/day group had a decrease of 9.8 ± 2.0/4.4 ± 2.5 mm Hg from 147.5 ± 9.5/91.9 ± 5.5 mm Hg at baseline.
References
- Coreg [package insert]. Ciales, PR: GK Pharmaceuticals Contract Manufacturing Operations; 2008.
- Coreg CR [package insert]. Ciales, PR: GK Pharmaceuticals Contract Manufacturing Operations; 2008.
- Whelton PK, Carey RM, Aronow WS, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol. 2018; 71 (19): e127-e248.
- McTavish D, Campoli-Richards D, Sorkin EM. Carvedilol. Drugs. 1993;45(2):232-258.
- Stienen U, Meyer-Sabellek W. Hemodynamic and metabolic effects of carvedilol: a meta-analysis approach. Clin Investig. 1992;70 Suppl 1:S65-72.
- Erdoðan O, Ertem B, Altun A. Comparison of antihypertensive efficacy of carvedilol and nebivolol in mild-to-moderate primary hypertension: a randomized trial. Anadolu Kardiyol Derg. 2011;11(4):310-313.
- Dupont AG. Effects of carvedilol on renal function. Eur J Clin Pharmacol. 1990;38 Suppl 2:S96-100.
- Bakris GL, Iyengar M, Lukas MA, Ordronneau P, Weber MA. Effect of combining extended-release carvedilol and lisinopril in hypertension: results of the COSMOS study. J Clin Hypertens. 2010;12(9):678-686.
- Widmann L, van der Does R, Hörrmann M, Machwirth M. Safety and antihypertensive efficacy of carvedilol and atenolol alone and in combination with hydrochlorothiazide. Eur J Clin Pharmacol. 1990;38(2):S143-S146.
