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A double-blind comparison of the effects of carvedilol and captopril on serum lipid concentrations in patients with mild to moderate essential hypertension and dyslipidaemia

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Summary

We have studied 250 patients with mild to moderate essential hypertension (diastolic blood pressure 95 – 114 mmHg) and dyslipidaemia (high-density lipoprotein cholesterol (HDL-C) below 1.03 mmol·l−1, total cholesterol 5.17–9.05 mmol·l−1, and triglycerides 2.26–5.64 mmol·l−1) in a controlled double-blind, multicentre, parallel group trial.

The patients took a fat-modified diet. After a 4-week placebo period, patients who continued to fulfil the selection criteria were randomly allocated to treatment with either carvedilol (a vasodilating β-blocker) 25–50 mg o.d. (n=116) or captopril (an ACE inhibitor) 25–50 mg o.d. (n=117) for 6 months.

In both groups there were favourable effects on the serum lipids. The relative changes (medians) in the carvedilol and captopril group were respectively: increase in HDL-C by 11% and 8%, decrease in total cholesterol by 11% and 10%, in low-density lipoprotein cholesterol by 16% and 12%, and in triglycerides by 13% and 14%. Equivalence of the two treatments was confirmed for the target variable change in HDL-C at a significance level of 5%.

Reductions in supine systolic/diastolic blood pressures were comparable in the two groups (carvedilol: 23/19 mmHg, captopril: 20/18 mmHg).

The improvement in lipid metabolism in patients treated with carvedilol is probably due to its α1-blocking properties.

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Authors and Affiliations

  1. Department of Clinical Research, Boehringer Mannheim GmbH, Mannheim, Germany

    U. Hauf-Zachariou, L. Widmann, B. Zülsdorf & P. D. Lang

  2. Department of Biometrics, Boehringer Mannheim GmbH, Mannheim, Germany

    M. Hennig

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  1. U. Hauf-Zachariou
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  2. L. Widmann
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  3. B. Zülsdorf
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  4. M. Hennig
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  5. P. D. Lang
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Hauf-Zachariou, U., Widmann, L., Zülsdorf, B. et al. A double-blind comparison of the effects of carvedilol and captopril on serum lipid concentrations in patients with mild to moderate essential hypertension and dyslipidaemia. Eur J Clin Pharmacol 45, 95–100 (1993). https://doi.org/10.1007/BF00315487

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