A double-blind comparison of the effects of carvedilol and captopril on serum lipid concentrations in patients with mild to moderate essential hypertension and dyslipidaemia

Abstract

We have studied 250 patients with mild to moderate essential hypertension (diastolic blood pressure 95-114 mmHg) and dyslipidaemia (high-density lipoprotein cholesterol (HDL-C) below 1.03 mmol.l-1, total cholesterol 5.17-9.05 mmol.l-1, and triglycerides 2.26-5.64 mmol.l-1) in a controlled double-blind, multicentre, parallel group trial. The patients took a fat-modified diet. After a 4-week placebo period, patients who continued to fulfil the selection criteria were randomly allocated to treatment with either carvedilol (a vasodilating beta-blocker) 25-50 mg o.d. (n = 116) or captopril (an ACE inhibitor) 25-50 mg o.d. (n = 117) for 6 months. In both groups there were favourable effects on the serum lipids. The relative changes (medians) in the carvedilol and captopril group were respectively: increase in HDL-C by 11% and 8%, decrease in total cholesterol by 11% and 10%, in low-density lipoprotein cholesterol by 16% and 12%, and in triglycerides by 13% and 14%. Equivalence of the two treatments was confirmed for the target variable change in HDL-C at a significance level of 5%. Reductions in supine systolic/diastolic blood pressures were comparable in the two groups (carvedilol: 23/19 mmHg, captopril: 20/18 mmHg). The improvement in lipid metabolism in patients treated with carvedilol is probably due to its alpha 1-blocking properties.

Lisinopril Decreases Plasma Free Testosterone in Male Hypertensive Patients and Increases Sex Hormone Binding Globulin in Female Hypertensive Patients.

“…However, this assumption was also excluded because the correlation between f-T change and the TC change was insignificant. Although the mechanism of the decrease in TC remains to be clarified, another ACEI has been reported to decrease TC levels (14).…”

Carvedilol in the Treatment of Hypertension - A Review of the Clinical Data Base

“…In 250 patients with mild-to-moderate essential hypertension and dyslipidemia, carvedilol and captopril were equipotent (72). Ö stergren et al have reported that carvedilol and enalapril have similar blood pressure lowering effects (73).…”

▼Carvedilol for hypertension

“…Rare unwanted effects have included bradycardia, cold hands and feet, angina pectoris, worsening of symptoms of intermittent claudication, depressed mood, rashes and sleep disturbance. Carvedilol does not appear to cause clinically significant changes in lipid profiles 17 , 18…”