Double-Blind, Controlled Clinical Trial to Evaluate the Antihypertensive Effect of Carvedilol in Elderly Patients with Mild to Moderate Hypertension

Staiger, C; Steger, W.; Widmann, L.; Ehmer, B.; Holtbrügge, Werner

doi:10.2165/00003495-198800366-00030

Cited by 6 publications

(5 citation statements)

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“…In younger patients, [3-blockers are generally regarded as first-line drugs for the treatment of hypertension. This and previous studies [7] show that carvedilol is a safe and well-B. Kr6nig et al: Carvedilol vs nitrendipine tolerated substance for the treatment of hypertension in elderly patients.…”

Section: Discussionsupporting

confidence: 78%

Blood-pressure-lowering effect of carvedilol vs nitrendipine in geriatric hypertensives

Krönig

Widmann

Staiger

et al. 1990

Eur J Clin Pharmacol

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Carvedilol and nitrendipine were given for 12 weeks in a double-blind study to 81 elderly patients (greater than or equal to 60 years) with essential hypertension. The effects on blood pressure were measured (Riva Rocci) before medication and after 2 h with the patient in a lying and standing position after 4 weeks of placebo therapy as well as after 4, 8 and 12 weeks of treatment. Carvedilol (25 mg/o.d.) reduced blood pressure measured in the supine and erect position very successfully, similar to the reduction achieved with nitrendipine (20 mg/o.d.), without influencing the pulse rate. Both substances were well tolerated. Carvedilol is an alternative substance for lowering high blood pressure in elderly hypertensive patients.

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Section: Discussionsupporting

confidence: 78%

Blood-pressure-lowering effect of carvedilol vs nitrendipine in geriatric hypertensives

Krönig

Widmann

Staiger

et al. 1990

Eur J Clin Pharmacol

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“…Carvedilol has been compared with both nitrendipine and pindolol in elderly patients with hypertension (Kronig et al 1990;Staiger et al 1988). Similar reductions in blood pressure were observed with both comparator drugs, and 90% of patients receiving carvedilol had a clinically significant reduction in blood pressure that was maintained during the 12-week study.…”

Section: Effects In the Elderlymentioning

confidence: 85%

Clinical Pharmacokinetics and Pharmacodynamics of Carvedilol

Morgan

1994

Clinical Pharmacokinetics

177

131

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Carvedilol is an arylethanolamine that is a racemic mixture of 2 enantiomers. The S-(-)-enantiomer has beta-adrenoceptor blocking activity, while the racemate also has alpha 1-receptor blocking activity due to the activity of the R-(+)-enantiomer. The drug is rapidly absorbed and undergoes extensive first-pass metabolism in the liver. It reaches a peak concentration 1 to 2 hours postdose and has an elimination half-life of about 4 to 7 hours. Absorption is delayed by food. The drug is highly lipophilic and is highly protein bound. The drug is metabolised by the liver, with some metabolites having biological activity. The pharmacokinetic profile is not altered in the elderly or in patients with renal disease. However, bioavailability of the oral medication is greatly increased in patients with liver disease. Carvedilol lowers blood pressure as a result of its beta-blocking and vasodilatory activity. The reduction in blood pressure is similar to that achieved with other antihypertensive drugs, and there are no adverse effects on renal or cerebral blood flow. Carvedilol has been used in small numbers of patients with cardiac failure. It reduces left ventricular hypertrophy and has no significant adverse metabolic effects.

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“…Certainly nothing carrying conviction has been reported [106,107]. Comparisons of carvedilol with pindolol [108] in the elderly have shown similar antihypertensive effects and side-effect profiles. A comparison of bisoprolol with nifedipine indicated equal antihypertensive potency but fewer side effects with bisoprolol [34].…”

Section: The Elderlymentioning

confidence: 99%

“…A comparison of bisoprolol with nifedipine indicated equal antihypertensive potency but fewer side effects with bisoprolol [34]. Celiprolol is well tolerated in the elderly [108][109][110].…”

Section: The Elderlymentioning

confidence: 99%

“…However, the pharmacokinetics of neither carvedilol nor celiprolol were found to change measurably with age [108,111,112]. While the improved cardiac functional aspects of newer agents such as dilevalol [59], celiprolol [24] and nebivolol [60,61] should increase their attractions in the elderly, there are at present no long-term comparative studies available to support this postulate.…”

Section: The Elderlymentioning

confidence: 99%

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