Haemodynamic effects of acute and chronic administration of low-dose carvedilol, a vasodilating β-blocker, in patients with cirrhosis and portal hypertension

Tripathi, D., Therapondos, G., Lui, H.F., Stanley, A.J. and Hayes, P.C. (2002) Haemodynamic effects of acute and chronic administration of low-dose carvedilol, a vasodilating β-blocker, in patients with cirrhosis and portal hypertension. Alimentary Pharmacology and Therapeutics, 16(3), pp. 373-380. (doi: 10.1046/j.1365-2036.2002.01190.x) (PMID:11876689)

Abstract

Background: Carvedilol is a non‐selective vasodilating β‐blocker with weak α1 receptor antagonism. Recent studies have demonstrated its potential as a portal hypotensive agent. Aim: To assess the haemodynamic effects and patient tolerability of the acute and chronic administration of low‐dose carvedilol. Methods: Haemodynamic measurements were performed in ten cirrhotic patients before and 1 h after the administration of 12.5 mg oral carvedilol. The study was repeated 4 weeks after daily administration of 12.5 mg carvedilol. Results: After acute administration of carvedilol, there was a 23% reduction in the hepatic venous pressure gradient from 16.37 ± 2.14 to 12.56 ± 3.91 mmHg (P < 0.05), with significant falls in the heart rate, mean arterial pressure and cardiac output. Chronic administration resulted in a further fall in the hepatic venous pressure gradient from a baseline of 16.37 ± 0.71 to 9.27 ± 1.40 mmHg (P < 0.001) with the mean arterial pressure being unaffected. The drug was well tolerated with only one patient experiencing asymptomatic hypotension. Conclusions: The results show that low‐dose carvedilol is an extremely potent portal hypotensive pharmacological agent, and is worthy of further investigation in large randomized trials to assess its effect in preventing variceal haemorrhage.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Stanley, Dr Adrian
• Authors: Tripathi, D., Therapondos, G., Lui, H.F., Stanley, A.J., and Hayes, P.C.
• College/School: College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
• Journal Name: Alimentary Pharmacology and Therapeutics
• Publisher: Wiley-Blackwell Publishing Ltd.
• ISSN: 0269-2813
• ISSN (Online): 1365-2036
• Published Online: 04 March 2002