Long-term effects of carvedilol on coronary flow reserve in hypertensive patients

The beneficial effect of beta-blockers on the treatment of patients with essential hypertension (EH) has been demonstrated,but there is evidence of differential effects among them. We assess the effects of Talliton (Carvedilol) on coronary flow reserve (CFR) in patients with EH. Methods: 54 , II WHO hypertensive patients ( 28 m, 26f, mean age 47,6 years) without coronary artery disease underwent standard Doppler echocardiography. The exam was performed at baseline and after 6-week monotherapy by Talliton in a daily dose of 12.5 mg. Results: At baseline the prevalence of left ventricular (LV) hypertrophy (LV mass index 50 g/m powered to 2.8) was 64.6% after 6-week Talliton therapy. Blood pressure (BP) decreased in 82.4% of the patients (p 0.01). Heart rate also significantly reduced (p 0.01).No change could be detected in LV mass index,relative wall thickness,fractional shortening and Doppler-derived diastolic inflow indexes.LV end-diatolic internal diameter and stroke volume tended to increase (p 0.06 and p 0.08 respectively). After 6-week therapy , CFR increased in 88.6% of the patients (p 0.0001). Conclusion: In patients with essential hypertension Talliton improves coronary flow reserve after 6-week therapy. This improvement occurs despite decrease in mean blood presuure and independently of changes in left ventricular mass.