Vascular Health and Risk Management (Dec 2008)
Controlled-release carvedilol in the management of systemic hypertension and myocardial dysfunction
Abstract
William H Frishman1, Linda S Henderson2, Mary Ann Lukas21Departments of Medicine and Pharmacology, New York Medical College/Westchester Medical Center, Valhalla, NY, USA; 2Cardiovascular and Metabolic Medicine Development Center, GlaxoSmithKline, Philadelphia, PA, USAAbstract: 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
