Hemodynamic profile of carvedilol.

Several so-called multiple-action compounds have been developed, such as medroxalol (alpha and beta blockade, and beta-2 stimulation), celiprolol (alpha-2 and beta-1 blockade, and beta-2 stimulation) and carvedilol (beta blockade and vasodilatation) for the treatment of patients with arterial hypertension and with coronary heart disease. Carvedilol exerts relatively uniform peripheral effects, i.e. a reduction of both systolic and diastolic blood pressure at rest and during exercise, and a decrease in the resting and exercise heart rate. Blood pressure fall due to carvedilol may be induced by its vasodilating effect, as documented by measurements of forearm blood flow and peripheral vascular resistance. Moreover, renal hemodynamics does not seem to be significantly altered by carvedilol. Carvedilol may also produce an improvement of the LV contractile status in patients with CHD and impaired LV function, mainly due to afterload reduction, in addition to its antianginal effect, which is due mainly to the beta-blocking properties of this substance. From the studies mentioned it may be concluded that carvedilol is a useful and promising drug for treating patients with both arterial hypertension and with coronary artery disease.