Springer Online Journal Archives 1860-2000
Chemistry and Pharmacology
Summary Carvedilol, a novel β-blocker with a vasodilating action, was given either alone (monotherapy) or with diuretics (combination therapy) to 42 patients with renal hypertension. The hypotensive effect, safety, and optimal dose were investigated. In all, 23 untreated patients (16 men and 7 women; average age, 56.4 ± 2.5 years) made up the monotherapy group and 19 diuretic-treated patients (11 men and 8 women; average age, 56.4 ± 2.5 years) comprised the combined therapy group. All subjects had an initial blood pressure (BP) of 〉 160/95 mmHg and were started on 5 mg/day oral carvedilol. The dose was gradually increased to a maximum of 20 mg/day, or until either the BP was reduced to 〈 149/89 mmHg or the reduction in mean BP was 〉 13 mmHg compared with baseline levels. The total study period was 8 weeks. With monotherapy, the BP and heart rate decreased significantly from 167/102 to 150/94 mmHg and from 81 to 74 beats/min, respectively. With combined therapy, the BP and heart rate fell significantly from 176/103 to 142/85 mmHg and from 81 to 70 beats/min, respectively. Responders were defined as subjects with a BP of ⩽ 149/89 mm Hg or those showing a fall of ⩽ 13 mmHg in mean BE Responders accounted for 52.2% of the monotherapy group and 73.6% of the combination therapy group. Orthostatic hypotension was not seen in either group. Serum creatinine and blood urea nitrogen (BUN) levels were not altered by administration of carvedilol. Dizziness was noted by 1 of the 23 subjects in the monotherapy group. These results suggest that carvedilol is an effective and well-tolerated antihypertensive agent for the management of renal hypertension. We considered the optimal dose to be from 10 to 20 mg once daily, which is similar to that recommended for essential hypertension.
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