Treatment of Chronic Stable Angina with Carvedilol: A Multiple-Action Neurohormonal Antagonist. A Review of Controlled Clinical Trials

Abstract

Beta-blockers and vasodilators, such as nitrates and calcium channel blockers, are all established antianginal therapies. These therapies have different antianginal mechanisms that dictate both their mode of action and their side-effect profile. An agent with both cardiac beta- and vascular alpha-receptor activity offers advantages over these conventional drugs. Carvedilol, a multiple-action neurohormonal antagonist, has potent antihypertensive and antianginal activity. Through its combination of pharmacological mechanisms, it reduces myocardial oxygen demand, increases myocardial blood supply and scavenges oxygen free radicals, which are capable of ischaemic damage. Studies have shown that carvedilol is at least as effective as other antianginal therapies in the management of chronic stable angina. Carvedilol is well tolerated – in several cases, the overall incidence of adverse events being lower than with other antianginal agents. These properties, combined with the documented antianginal effects, suggest that carvedilol may prove useful for the treatment of patients with chronic stable angina.