Carvedilol: a third-generation β-blocker should be a first-choice β-blocker

Expert Rev Cardiovasc Ther. 2012 Jan;10(1):13-25. doi: 10.1586/erc.11.166.

Abstract

β-Blockers are a standard of care in many clinical settings such as acute myocardial infarction, heart failure and patients at risk for a coronary event. However, not all β-blockers are the same and they vary in properties such as lipophilicity, metabolic profile, receptor inhibition, hemodynamics, tolerability and antioxidant/anti-inflammatory effects. It has been unclear whether these differences affect outcomes or if one β-blocker should be preferred over another. This review will summarize the properties of metoprolol, atenolol and carvedilol, as well as comparative experimental and clinical trials between these agents. We will provide compelling evidence of why carvedilol should be a first-line β-blocker and why it offers many advantages over the β1-selective β-blockers.

Publication types

  • Comparative Study
  • Review

MeSH terms

  • Adrenergic beta-Antagonists / adverse effects
  • Adrenergic beta-Antagonists / pharmacokinetics
  • Adrenergic beta-Antagonists / therapeutic use*
  • Animals
  • Antihypertensive Agents / adverse effects
  • Antihypertensive Agents / pharmacokinetics
  • Antihypertensive Agents / therapeutic use*
  • Atenolol / adverse effects
  • Atenolol / pharmacokinetics
  • Atenolol / therapeutic use
  • Biomarkers / blood
  • Carbazoles / adverse effects
  • Carbazoles / pharmacokinetics
  • Carbazoles / therapeutic use*
  • Carvedilol
  • Humans
  • Hypertension / blood
  • Hypertension / drug therapy*
  • Hypertension / metabolism
  • Hypertension / physiopathology
  • Metoprolol / adverse effects
  • Metoprolol / pharmacokinetics
  • Metoprolol / therapeutic use
  • Myocardial Infarction / etiology
  • Myocardial Infarction / prevention & control
  • Propanolamines / adverse effects
  • Propanolamines / pharmacokinetics
  • Propanolamines / therapeutic use*
  • Secondary Prevention
  • Sympathetic Nervous System / drug effects
  • Vasodilator Agents / adverse effects
  • Vasodilator Agents / pharmacokinetics
  • Vasodilator Agents / therapeutic use

Substances

  • Adrenergic beta-Antagonists
  • Antihypertensive Agents
  • Biomarkers
  • Carbazoles
  • Propanolamines
  • Vasodilator Agents
  • Carvedilol
  • Atenolol
  • Metoprolol