Controlled-release carvedilol in the management of systemic hypertension and myocardial dysfunction

Review

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Authors: William H Frishman, Linda S Henderson, Mary Ann Lukas

Published Date December 2008 Volume 2008:4(6) Pages 1387 - 1400

DOI: http://dx.doi.org/10.2147/VHRM.S3148

William H Frishman¹, Linda S Henderson², Mary Ann Lukas²

¹Departments of Medicine and Pharmacology, New York Medical College/Westchester Medical Center, Valhalla, NY, USA; ²Cardiovascular and Metabolic Medicine Development Center, GlaxoSmithKline, Philadelphia, PA, USA

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