Comparison of the Effects of Carvedilol and Nifedipine in Patients with Essential Hypertension and Non-Insulin-Dependent Diabetes Mellitus

Albergati, Francesco; Paternò, Emanuela; Venuti, Robert P.; Boeri, D; Lombardo, Ilise; Semino, Silvana Noemí; Viviani, Giorgio Luciano; Adezati, L

doi:10.1097/00005344-199219001-00017

Cited by 16 publications

(7 citation statements)

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“…No effect on glucose or glycohemoglobin (HBA,) levels or antidiabetic drug requirements was demonstrated with carvedilol treatment in diabetic patients (type 2) in comparison to metoprolol (27). A recently reported trial also showed no difference in the effect of glucose tolerance testing between carvedilol and nifedipine SR in non-insulindependent diabetics treated for 4 weeks (2).…”

Section: Metabolic and Endocrine Effectsmentioning

confidence: 96%

Carvedilol: A Novel Cardiovascular Drug with Multiple Actions

Ruffolo

Boyle

Brooks

et al. 1992

Cardiovascular Drug Reviews

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Carvedilol (Fig. 1) is a novel multiple action drug that has recently been introduced to the market for the treatment of mild to moderate hypertension (7,8,2426). In extensive clinical trials conducted worldwide, comparisons to all major classes of antihypertensive agents, including captopril, nifedipine, and atenolol, have demonstrated that once-daily therapy with carvedilol is both highly efficacious and possesses a favorable side effect profile. Clinical trials are currently in progress to establish the utility of carvedilol in angina and congestive heart failure.Carvedilol is both a competitive P-adrenoceptor antagonist (76,93,94) and an arterial vasodilator (73). At higher concentrations, carvedilol is also a calcium channel antagonist (73,75,93,94). The vasodilatory actions result primarily from a,-adrenoceptor blockade (73,75,76), although in certain vascular beds, calcium channel blockade may also contribute to vasodilation (96,124). In addition to these actions on the heart and vasculature, carvedilol has also been shown to possess significant antioxidant and antiproliferative actions. These multiple actions are responsible for the antihypertensive efficacy of the drug in animals (93,94,105,106) and in humans (7,8,24-26), and may also work in conjunction to provide effective therapy in angina and congestive heart failure.The antihypertensive response produced by carvedilol is associated with a decrease in peripheral vascular resistance with either no change or only a moderate reduction in heart rate. The reduction in peripheral vascular resistance produced by carvedilol is indicative of arterial vasodilation (7,8,108), and the lack of reflex tachycardia is a direct consequence of the P-adrenoceptor blocking property of the drug (7).Carvedilol has been shown in animal models to protect all the major organ systems that comprise the cardiovascular system, specifically the kidney, heart, vasculature, and brain.

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Section: Metabolic and Endocrine Effectsmentioning

confidence: 96%

Carvedilol: A Novel Cardiovascular Drug with Multiple Actions

Ruffolo

Boyle

Brooks

et al. 1992

Cardiovascular Drug Reviews

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show abstract

“…An isoglycemic, hyperinsulinemic glucose clamp was conducted at baseline and after 12 weeks of treatment with either metoprolol or carvedilol. Insulin sensitivity decreased significantly after metoprolol whereas it increased after carvedilol (89).…”

Section: Glucose Metabolism and Insulin Sensitivitymentioning

confidence: 86%

“…Unlike some b -blockers carvedilol does not exert negative influences on glucose homeostasis as assessed in hypertensive patients with non-insulin-dependent diabetes mellitus (69,88).…”

Section: Diabetes Mellitusmentioning

confidence: 97%

“…In a study of patients with essential hypertension and non-insulin-dependent (type II) diabetes mellitus, carvedilol and nifedipine produced similar lowering of blood pressure (69). Moreover, carvedilol was compared with nifedipine in a multicenter double-blind trial in 106 mild-to-moderate hypertensive patients and both agents were equally effective (70).…”

Section: Comparisons With Calcium Antagonistsmentioning

confidence: 99%

“…In non-insulin-dependent diabetics after 4 weeks of carvedilol treatment, blood glucose concentrations were maintained within narrow limits and glycated hemoglobin A1 also remained unchanged (88). Carvedilol has also been shown to improve glucose tolerance (89). An isoglycemic, hyperinsulinemic glucose clamp was conducted at baseline and after 12 weeks of treatment with either metoprolol or carvedilol.…”

Section: Glucose Metabolism and Insulin Sensitivitymentioning

confidence: 99%

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

Hansson

Himmelmänn²

1998

Scandinavian Cardiovascular Journal

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Scand Cardiovasc J Suppl 47: 67-80, 1998. Carvedilol is a novel antihypertensive agent. It is a multiple-action neurohormonal antagonist with a beta-adrenoceptor blocking effect combined with a vasodilating action based on alpha 1 -adrenoceptor blockade. In addition, carvedilol exerts a number of well documented ancillary effects such as being a scavenger of free radicals. It also has an antiproliferative action on smooth muscle cells. This combination of effects opens up a number of interesting clinical perspectives. It is the purpose of this brief review to summarize some of the clinical studies that have been performed with carvedilol. Investigations in hypertensive patients will form the basis of this review, but special interest will also be devoted to other patient groups. In particular the therapeutic value of carvedilol will be discussed in patients with concomitant disorders such as atheromatosis, left ventricular hypertrophy, angina pectoris, myocardial infarction, congestive heart failure, arrhythmias, stroke, renal failure or diabetes. Finally, the usefulness of carvedilol in the treatment of elderly hypertensive patients will be reviewed. It is evident from the available scientific literature that carvedilol is an antihypertensive agent with a novel mode of action. It is effective in many of the subpopulations of patients alluded to above. It appears reasonable to assume that some of these therapeutic effects can be attributed to its ancillary properties. Scand Cardiovasc J 32 REVIEW ARTICLE Scand Cardiovasc J Downloaded from informahealthcare.com by Nyu Medical Center on 06/17/15 For personal use only. 68 L. Hansson and A. Himmelmann Scand Cardiovasc J 32 Scand Cardiovasc J Downloaded from informahealthcare.com by Nyu Medical Center on 06/17/15 For personal use only. Scand Cardiovasc J 32 Scand Cardiovasc J Downloaded from informahealthcare.com by Nyu Medical Center on 06/17/15 For personal use only.

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The Autonomic Nervous System

Glick¹

2010

Miller's Anesthesia

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Comparison of the Effects of Carvedilol and Nifedipine in Patients with Essential Hypertension and Non-Insulin-Dependent Diabetes Mellitus

Cited by 16 publications

References 0 publications

Carvedilol: A Novel Cardiovascular Drug with Multiple Actions

Carvedilol: A Novel Cardiovascular Drug with Multiple Actions

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

The Autonomic Nervous System

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