Carvedilol was studied for its efficacy and safety in treating hypertension, especially in high-risk elderly patients and those with diabetes or renal disease. Over 12 weeks, carvedilol alone or combined with other drugs significantly reduced blood pressure from 168/95 mmHg to 144/83 mmHg. Nearly half of patients achieved their blood pressure goals. Carvedilol was well-tolerated with few side effects and did not negatively impact glucose or renal function in high-risk patients. The study concluded that carvedilol is an effective and safe option for treating hypertension, including in elderly patients and those with complications.

1. Drugs R D 2011

2. Background
 The management of hypertension should be based on
the presence or absence of other risk factors.
 If hypertension is complicated with risk factors, such
as diabetes mellitus, target organ damage or renal
dysfunction, aggressive management of
hypertension is important to attain target BP goals.
 It is difficult to achieve target BP goals with a single
antihypertensive drug and often combined
administration of two or more drugs is required.

3. Background
 b-Blockers are aggressively indicated for the treatment
of hypertension associated with angina, MI,
tachycardia, and HF, and are recommended for the
prevention of recurrence of MI or occurrence of IHD.
 Clinical studies have demonstrated that carvedilol has
a long-lasting antihypertensive effect without
adversely affecting glucose/lipid metabolism,
alone or in combination.

4. Study Aim
 To assess the efficacy and safety of carvedilol alone and
in combination with other drugs, in
 elderly patients
 High risk patients with diabetes
 renal disease

5. Study design
 This was a prospective survey.
 The standard observation period for the patients was
defined as 12 weeks of treatment with carvedilol.
 44.6 % started with 10 mg carvedilol daily
 54.9 % started with 20 mg carvedilol daily.

6. Method

7. Patient criteria
 Age > 65 years.
 Essential hypertension.
 Renal parenchymal hypertension (2 %).
 Carvedilol naïve.
 Severity (WHO classification).
 59 % Grad 1 (140-159/90-99)
 22 % grad 2 (160-179/100-109)
 12 % grad 3 (> 180/110)
 54 % Previous antihypertensive medications (CCBs, ACEi,
diuretics and a-blockers).
 46 % used carvedilol as monotherapy.
 Average base line of blood presure is 168/95 mmhg.

8. Results
168.2 /95.7 mmHg
144.3 /83.4 mmHg

10. Sustained antihypertensive effect
of carvedilol from second week

11. % patient achieve blood presure
goals

12. Safety

13. Discussion
 These results indicate that carvedilol exerts reasonable
BP reduction regardless of whether it is used as
monotherapy or in combination therapy, and that the
effect is not influenced by the coadministered drug.
 carvedilol was also effective in reducing BP levels in
elderly patients (>65 years) and in patients with
diabetes mellitus or renal diseases.

14. Discussion
 Fasting blood glucose levels in patients with diabetes were
163.4 – 64.7 mg/dL at baseline and 148.5 – 54.1 mg/dL at the
end of treatment, without an adverse change from
baseline.
 Among reported metabolic and nutritional disorders, the
ADRs related to glucose metabolism were only one
event each of hyperglycemia, sugar blood level increased,
hypoglycemia, and sugar in the urine1 from three patients,
none were considered serious.
 carvedilol also demonstrated to have a favorable
antihypertensive effect in patients with renal disease
complications, while not aggravating their renal function.

15. Conclusion
Carvedilol was confirmed to be safe
and effective when used in patients
with hypertension in daily clinical
practice, and was also safely used with a
good antihypertensive effect in elderly
patients and in those with diabetes or
renal disease complications.

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