Carvedilol may also be better tolerated in patients with peripheral vascular disease and diabetes, in whom peripheral vasoconstriction secondary to unopposed alpha blockade with nonselective beta-blockers may contribute to worsening of symptoms.
In conclusion, carvedilol appears to be comparable in activity with other antihypertensive drugs — . However, because carvedilol does not offer significant advantages over existing beta-blockers or other antihypertensives, it has not been marketed in Canada for hypertension.
CARVEDILOL IN CORONARY ARTERY DISEASE
Carvedilol appears to be effective in the management of stable angina, increasing exercise tolerance and time to chest pain or ST segment depression on the electrocardiogram . Compared with other beta-blockers (eg, atenolol), carvedilol does not appear to be more effective , suggesting that the beneficial effects of carvedilol in angina may be mediated primarily through beta-blockade rather than through its vasodi-latory properties. In addition, maximal doses of carvedilol (50 mg orally bid) are required to optimize its antianginal effects.
Although carvedilol is not approved for use in the treatment of angina pectoris, it may be useful in patients with CHF secondary to long-standing coronary artery disease, where other beta-blockers or calcium channel blockers are not tolerated due to their negative inotropic properties.