Endothelial function is unaffected by changing between carvedilol and metoprolol in patients with heart failure--a randomized study

Britt Falskov; Thomas Steffen Hermann; Jakob Raunsø; Buris Christiansen; Christian Rask-Madsen; Atheline Major-Pedersen; Lars Køber; Christian Torp-Pedersen; Helena Dominguez

doi:10.1186/1475-2840-10-91

Endothelial function is unaffected by changing between carvedilol and metoprolol in patients with heart failure--a randomized study

Britt Falskov, Thomas Steffen Hermann, Jakob Raunsø, Buris Christiansen, Christian Rask-Madsen, Atheline Major-Pedersen, Lars Køber, Christian Torp-Pedersen, Helena Dominguez

7 Citationer (Scopus)

Abstract

BACKGROUND: Carvedilol has been shown to be superior to metoprolol tartrate to improve clinical outcomes in patients with heart failure (HF), yet the mechanisms responsible for these differences remain unclear. We examined if there were differences in endothelial function, insulin stimulated endothelial function, 24 hour ambulatory blood pressure and heart rate during treatment with carvedilol, metoprolol tartrate and metoprolol succinate in patients with HF.

METHODS: Twenty-seven patients with mild HF, all initially treated with carvedilol, were randomized to a two-month treatment with carvedilol, metoprolol tartrate or metoprolol succinate. Venous occlusion plethysmography, 24-hour blood pressure and heart rate measurements were done before and after a two-month treatment period.

RESULTS: Endothelium-dependent vasodilatation was not affected by changing from carvedilol to either metoprolol tartrate or metoprolol succinate. The relative forearm blood flow at the highest dose of serotonin was 2.42 ± 0.33 in the carvedilol group at baseline and 2.14 ± 0.24 after two months continuation of carvedilol (P = 0.34); 2.57 ± 0.33 before metoprolol tartrate treatment and 2.42 ± 0.55 after treatment (p = 0.74) and in the metoprolol succinate group 1.82 ± 0.29 and 2.10 ± 0.37 before and after treatment, respectively (p = 0.27). Diurnal blood pressures as well as heart rate were also unchanged by changing from carvedilol to metoprolol tartrate or metoprolol succinate.

CONCLUSION: Endothelial function remained unchanged when switching the beta blocker treatment from carvedilol to either metoprolol tartrate or metoprolol succinate in this study, where blood pressure and heart rate also remained unchanged in patients with mild HF.

TRIAL REGISTRATION: Current Controlled Trials NCT00497003.

Originalsprog	Engelsk
Tidsskrift	Cardiovascular Diabetology
Vol/bind	10
Sider (fra-til)	91
ISSN	1475-2840
DOI	https://doi.org/10.1186/1475-2840-10-91
Status	Udgivet - 15 okt. 2011

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10.1186/1475-2840-10-91Licens: CC BY

1475-2840-10-91Forlagets udgivne version, 432 KBLicens: CC BY

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title = "Endothelial function is unaffected by changing between carvedilol and metoprolol in patients with heart failure--a randomized study",

abstract = "BACKGROUND: Carvedilol has been shown to be superior to metoprolol tartrate to improve clinical outcomes in patients with heart failure (HF), yet the mechanisms responsible for these differences remain unclear. We examined if there were differences in endothelial function, insulin stimulated endothelial function, 24 hour ambulatory blood pressure and heart rate during treatment with carvedilol, metoprolol tartrate and metoprolol succinate in patients with HF.METHODS: Twenty-seven patients with mild HF, all initially treated with carvedilol, were randomized to a two-month treatment with carvedilol, metoprolol tartrate or metoprolol succinate. Venous occlusion plethysmography, 24-hour blood pressure and heart rate measurements were done before and after a two-month treatment period.RESULTS: Endothelium-dependent vasodilatation was not affected by changing from carvedilol to either metoprolol tartrate or metoprolol succinate. The relative forearm blood flow at the highest dose of serotonin was 2.42 ± 0.33 in the carvedilol group at baseline and 2.14 ± 0.24 after two months continuation of carvedilol (P = 0.34); 2.57 ± 0.33 before metoprolol tartrate treatment and 2.42 ± 0.55 after treatment (p = 0.74) and in the metoprolol succinate group 1.82 ± 0.29 and 2.10 ± 0.37 before and after treatment, respectively (p = 0.27). Diurnal blood pressures as well as heart rate were also unchanged by changing from carvedilol to metoprolol tartrate or metoprolol succinate.CONCLUSION: Endothelial function remained unchanged when switching the beta blocker treatment from carvedilol to either metoprolol tartrate or metoprolol succinate in this study, where blood pressure and heart rate also remained unchanged in patients with mild HF.TRIAL REGISTRATION: Current Controlled Trials NCT00497003.",

keywords = "Aged, Aged, 80 and over, Carbazoles, Drug Substitution, Endothelium, Vascular, Female, Heart Failure, Humans, Male, Metoprolol, Middle Aged, Propanolamines, Vasodilation",

author = "Britt Falskov and Hermann, {Thomas Steffen} and Jakob Rauns{\o} and Buris Christiansen and Christian Rask-Madsen and Atheline Major-Pedersen and Lars K{\o}ber and Christian Torp-Pedersen and Helena Dominguez",

year = "2011",

month = oct,

day = "15",

doi = "10.1186/1475-2840-10-91",

language = "English",

volume = "10",

pages = "91",

journal = "Cardiovascular Diabetology",

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TY - JOUR

T1 - Endothelial function is unaffected by changing between carvedilol and metoprolol in patients with heart failure--a randomized study

AU - Falskov, Britt

AU - Hermann, Thomas Steffen

AU - Raunsø, Jakob

AU - Christiansen, Buris

AU - Rask-Madsen, Christian

AU - Major-Pedersen, Atheline

AU - Køber, Lars

AU - Torp-Pedersen, Christian

AU - Dominguez, Helena

PY - 2011/10/15

Y1 - 2011/10/15

N2 - BACKGROUND: Carvedilol has been shown to be superior to metoprolol tartrate to improve clinical outcomes in patients with heart failure (HF), yet the mechanisms responsible for these differences remain unclear. We examined if there were differences in endothelial function, insulin stimulated endothelial function, 24 hour ambulatory blood pressure and heart rate during treatment with carvedilol, metoprolol tartrate and metoprolol succinate in patients with HF.METHODS: Twenty-seven patients with mild HF, all initially treated with carvedilol, were randomized to a two-month treatment with carvedilol, metoprolol tartrate or metoprolol succinate. Venous occlusion plethysmography, 24-hour blood pressure and heart rate measurements were done before and after a two-month treatment period.RESULTS: Endothelium-dependent vasodilatation was not affected by changing from carvedilol to either metoprolol tartrate or metoprolol succinate. The relative forearm blood flow at the highest dose of serotonin was 2.42 ± 0.33 in the carvedilol group at baseline and 2.14 ± 0.24 after two months continuation of carvedilol (P = 0.34); 2.57 ± 0.33 before metoprolol tartrate treatment and 2.42 ± 0.55 after treatment (p = 0.74) and in the metoprolol succinate group 1.82 ± 0.29 and 2.10 ± 0.37 before and after treatment, respectively (p = 0.27). Diurnal blood pressures as well as heart rate were also unchanged by changing from carvedilol to metoprolol tartrate or metoprolol succinate.CONCLUSION: Endothelial function remained unchanged when switching the beta blocker treatment from carvedilol to either metoprolol tartrate or metoprolol succinate in this study, where blood pressure and heart rate also remained unchanged in patients with mild HF.TRIAL REGISTRATION: Current Controlled Trials NCT00497003.

AB - BACKGROUND: Carvedilol has been shown to be superior to metoprolol tartrate to improve clinical outcomes in patients with heart failure (HF), yet the mechanisms responsible for these differences remain unclear. We examined if there were differences in endothelial function, insulin stimulated endothelial function, 24 hour ambulatory blood pressure and heart rate during treatment with carvedilol, metoprolol tartrate and metoprolol succinate in patients with HF.METHODS: Twenty-seven patients with mild HF, all initially treated with carvedilol, were randomized to a two-month treatment with carvedilol, metoprolol tartrate or metoprolol succinate. Venous occlusion plethysmography, 24-hour blood pressure and heart rate measurements were done before and after a two-month treatment period.RESULTS: Endothelium-dependent vasodilatation was not affected by changing from carvedilol to either metoprolol tartrate or metoprolol succinate. The relative forearm blood flow at the highest dose of serotonin was 2.42 ± 0.33 in the carvedilol group at baseline and 2.14 ± 0.24 after two months continuation of carvedilol (P = 0.34); 2.57 ± 0.33 before metoprolol tartrate treatment and 2.42 ± 0.55 after treatment (p = 0.74) and in the metoprolol succinate group 1.82 ± 0.29 and 2.10 ± 0.37 before and after treatment, respectively (p = 0.27). Diurnal blood pressures as well as heart rate were also unchanged by changing from carvedilol to metoprolol tartrate or metoprolol succinate.CONCLUSION: Endothelial function remained unchanged when switching the beta blocker treatment from carvedilol to either metoprolol tartrate or metoprolol succinate in this study, where blood pressure and heart rate also remained unchanged in patients with mild HF.TRIAL REGISTRATION: Current Controlled Trials NCT00497003.

KW - Aged

KW - Aged, 80 and over

KW - Carbazoles

KW - Drug Substitution

KW - Endothelium, Vascular

KW - Female

KW - Heart Failure

KW - Humans

KW - Male

KW - Metoprolol

KW - Middle Aged

KW - Propanolamines

KW - Vasodilation

U2 - 10.1186/1475-2840-10-91

DO - 10.1186/1475-2840-10-91

M3 - Journal article

C2 - 21999413

SN - 1475-2840

VL - 10

SP - 91

JO - Cardiovascular Diabetology

JF - Cardiovascular Diabetology

ER -

Endothelial function is unaffected by changing between carvedilol and metoprolol in patients with heart failure--a randomized study

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