CARVEDILOL IN THE TREATMENT OF HYPERTENSION - A REVIEW OF THE CLINICAL-DATA BASE

Carvedilol is a novel antihypertensive agent. It is a multiple-action neurohormonal antagonist with a beta-adrenoceptor blocking effect comb ined with a vasodilating action based on alpha(1)-adrenoceptor blockad e. In addition, carvedilol exerts a number of well documented ancillar y effects such as being a scavenger of free radicals. It also has an a ntiproliferative action on smooth muscle cells. This combination of ef fects opens up a number of interesting clinical perspectives. It is th e purpose of this brief review to summarize some of the clinical studi es that have been performed with carvedilol. Investigations in hyperte nsive patients will form the basis of this review, but special interes t will also be devoted to other patient groups. In particular the ther apeutic value of carvedilol will be discussed in patients with concomi tant disorders such as atheromatosis, left ventricular hypertrophy, an gina pectoris, myocardial infarction, congestive heart failure, arrhyt hmias, stroke, renal failure or diabetes. Finally, the usefulness of c arvedilol in the treatment of elderly hypertensive patients will be re viewed. It is evident from the available scientific literature that ca rvedilol is an antihypertensive agent with a novel mode of action. It is effective in many of the subpopulations of patients alluded to abov e. It appears reasonable to assume that some of these therapeutic effe cts can be attributed to its ancillary properties.