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Posted: May 5th, 2020
Carvedilol is a drug belonging to a class of drugs known as alpha and beta-blockers known to have a similar mode of action and to treat the same conditions. Carvedilol is the most present form within this group of drugs and is used to lower high blood pressure and treat congestive heart failure. It improves the functioning of a heart that is not pumping well after a heart attack, improving chances of recovery. By lowing high blood pressure, carvedilol also reduces other health complications associated with high blood pressure, including stroke, heart attack, and kidney problems.
For more than four decades, beta blockers have been effectively used to treat high blood pressure. But while still effective in lowering BP, the effects of beta blockers on the cardiovascular morbidity and mortality in patients with hypertension remains a major controversial matter to date. However, most of these studies derive their findings from the effects of older agents, including the metoprolol and atenolol.
Still, there is significant heterogeneity in the pharmacokinetic and pharmacodynamics of these older agents with the present class of beta blockers. But carvedilol, a vasodilating and non-cardioselective agent and the most present beta blocker has been seen to be more effective in lowering BP. It allows a provider to use a cardioprotective agent without the concern of hemodynamic and metabolic actions associated with older agents.
Unlike the traditional beta blockers, carvedilol has been shown to have more benefits such as maintaining cardiac output. Carvedilol is evidenced to have a less extended impact on the heart rate compared to conventional beta blockers. Studies have also shown that carvedilol has a more neutral effect on other major metabolic parameters such as insulin sensitivity, glycemic control, and lipid metabolism. This shows that carvedilol can be used on patients with these and other metabolic conditions like diabetes with minimal or no side effects.
Mechanism of Action
It is not clear exactly how carvedilol works, but it is believed to lower high blood pressure by reducing the vascular resistance. It works by inhibiting the actions of various naturally occurring substances within the body, such as epinephrine on blood vessels and the heart. Epinephrine, commonly known as adrenaline, is produced when one experiences strong emotions such as anger or fear, increasing the heart rate and blood pressure. Carvedilol blocks the action of epinephrine, and the result is a slower heart rate and reduced blood pressure, which in turn reduces the strain exerted on the heart. Carvedilol also works by widening the blood vessels, lowering the blood pressure.
References
Del Mauro, Julieta S., et al. “Effects of carvedilol or amlodipine on target organ damage in L-NAME hypertensive rats: their relationship with blood pressure variability.” Journal of the American Society of Hypertension 11.4 (2017): 227-240.
Dominguez, Renata F., et al. “Hypertensive heart disease: Benefit of carvedilol in hemodynamic, left ventricular remodeling, and survival.” SAGE open medicine 7 (2019): 2050312118823582.
Farha, Samar, et al. “Pulmonary arterial hypertension treatment with carvedilol for heart failure: a randomized controlled trial.” JCI insight 2.16 (2017).
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