Abstract
Cardiovascular disease is the leading cause of death worldwide. Within the treatment armamentarium, beta-blockers have demonstrated efficacy across the spectrum of cardiovascular disease--from modification of a risk factor (ie, hypertension) to treatment after an acute event (ie, myocardial infarction). Recently, the use of beta-blockers as a first-line therapy in hypertension has been called into question. Moreover, beta-blockers as a class are saddled with a misperception of having poor tolerability. However, vasodilatory beta-blockers such as carvedilol have a different hemodynamic action that provides the benefits of beta-blockade with the addition of vasodilation resulting from alpha 1-adrenergic receptor blockade. Vasodilation reduces total peripheral resistance, which may produce an overall positive effect on tolerability. Recently, a new, controlled-release carvedilol formulation has been developed that provides the clinical efficacy of carvedilol but is indicated for once-daily dosing. This review presents an overview of the clinical and pharmacologic carvedilol controlled-release data.
Keywords:
beta-blockers; cardiovascular disease; heart failure; myocardial infarction; vasodilatory.
MeSH terms
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Adrenergic alpha-Antagonists / adverse effects
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Adrenergic alpha-Antagonists / pharmacokinetics
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Adrenergic alpha-Antagonists / therapeutic use*
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Adrenergic beta-Antagonists / adverse effects
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Adrenergic beta-Antagonists / pharmacokinetics
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Adrenergic beta-Antagonists / therapeutic use*
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Antihypertensive Agents / adverse effects
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Antihypertensive Agents / pharmacokinetics
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Antihypertensive Agents / therapeutic use*
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Carbazoles / adverse effects
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Carbazoles / pharmacokinetics
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Carbazoles / therapeutic use*
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Carvedilol
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Delayed-Action Preparations
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Drug Administration Schedule
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Heart Diseases / drug therapy*
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Heart Diseases / etiology
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Heart Diseases / physiopathology
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Heart Failure / drug therapy
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Hemodynamics / drug effects
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Humans
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Hypertension / complications
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Hypertension / drug therapy*
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Hypertension / physiopathology
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Medication Adherence
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Patient Satisfaction
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Propanolamines / adverse effects
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Propanolamines / pharmacokinetics
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Propanolamines / therapeutic use*
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Quality of Life
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Treatment Outcome
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Vasodilator Agents / adverse effects
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Vasodilator Agents / pharmacokinetics
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Vasodilator Agents / therapeutic use*
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Ventricular Dysfunction, Left / drug therapy
Substances
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Adrenergic alpha-Antagonists
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Adrenergic beta-Antagonists
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Antihypertensive Agents
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Carbazoles
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Delayed-Action Preparations
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Propanolamines
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Vasodilator Agents
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Carvedilol