Efficacy of Carvedilol vs Metoprolol on Blood Pressure in Patients with Essential Hypertension

Objective To compare the clinical efficacy of two β|adrenoceptor antagonists(carvedilol and metoprolol) in the treatment of essential hypertension using ambulatory blood pressure monitoring(ABPM). Methods Seventy-eight patients with essential hypertension were enrolled in the study. The patients were randomly assigned to receive carvedilol group(25-50 mg/d,n=39) and metoprolol group(100-200 mg,Bid,n=39) for 12 weeks. 24 h blood pressure,day time and night time BP,every time point of 24 h ABPM,as well as T/P ratios before and after 12 weeks treatment were determined. Results At the end of the 12 week,the mean systolic blood pressure SBP/DBP of 24 h,day time and night time were decreased markedly in two groups. In carvedilol group SBP/DBP were decreased at every time point of 24 h ABPM. In metoprolol group although SBP/DBP were also decreased at most time points,but not significant between 23-24th hour after the usage of medication(P0.05). The mean trough/peak ratio in carvedilol group and metoprolol group for SBP was 63% and 57%,DBP was 59% and 51%. Conclusion Although good trough/peak ratio has been shown in both carvedilol and metoprolol,carvedilol (25-50 mg/d) reduced blood pressure smoothly for 24 h,while metoprolol (100-200 mg,Bid) could keeps the decreased BP for only 22 h in some patients.