Carvedilol: shows similar antianginal efficacy but less potent P-blockade to equivalent doses of atenolol

The antiangmal efficacies of the non-select1ve beta-blocker carvedllol [BM 14190 Boehnnger Mannhe1m] and atenolol were compared 1n 12 patients w1th stable effort ang1na 1n a double-blind study After a run-In penod. the pat1ents rece1ved single doses of carvedilol 25mg, 50mg and placebo. 1n a random order w1th 48 hours between treatments Patients then received a single dose of atenolol 50mg 1n a s1ngle-blind design.

Carvedilol 50mg and atenolol 50mg decreased HR at rest by 11 and 12 beats/min. respectively Systolic BP at rest decreased by 11 and 5mm Hg. respectively Exercise duration mcreased from 0.8 min to 11 .8 mm after carvedilol 25mg, 13.4 min after carvedilol 50mg and 14 5 min after atenolol 50mg. Time to angina mcreased from 7.8 m1n to 84, 10.5 and 11.8 min. respectively T1me to 1 m1n ST segment depression was significantly h1gher after atenolol 50mg than after carvedilol 50mg (10.9 vs 8.3 min). Maximal HR significantly decreased from 119 beats/mm to 109 and 107 beatsjm1n after carvedilol 50mg and atenolol 50mg, respectively. Carved1lol 50mg significantly decreased maximal systolic BP from 170 to 152mm Hg. Rate-pressure product at 1mm ST segment depress1on was significantly lower after carvedilol 50mg than after atenolol 50mg Compared w1th placebo. carvedilol 25mg sign1f1cantly 1ncreased time to 1 mm ST segment depression from 5 4 to 6 7 min and significantly decreased HR at angma from 109 to 103 beats; m1n

The authors concluded that ' ... /3 blockade was less pot.:nt with carvedilol than with atenolol' and that carvedilol 50mg and atenolol 50mg ' ... had similar antianginal efficacy'.

6 JNPHARMA' 12 December 1987 0156-27031 87. 1212-0006 0$01 00 0 ,c:, ADIS Press