Abstract
Dosing equivalency of carvedilol and metoprolol remains a debate. Degree of β1-blockade is best assessed by blunting of the exercise-induced heart rate. Accordingly, the authors have investigated dosing equivalency by examining baseline and peak exercise heart rates and norepinephrine levels in subjects with chronic heart failure treated with carvedilol or metoprolol. Thirty-seven subjects treated with carvedilol (32.9 ± 3.5 mg; n = 23) or metoprolol succinate (XL) (96.4 ± 15.9 mg; n = 14) referred for cardiopulmonary exercise testing were studied prospectively. Carvedilol versus metoprolol XL subjects did not differ with respect to baseline heart rate (73 ± 2 vs 70 ± 3 bpm), or baseline plasma norepinephrine levels (597.5 ± 78.3 vs 602.1 ± 69.6 pg/mL), P = NS. However, despite similar peak exercise norepinephrine levels (2735.8 ± 320.1 vs 2403.1 ± 371.6 pg/mL), heart rate at peak exercise was higher in subjects receiving carvedilol (135 ± 4 bpm) than those receiving metoprolol XL (117 ± 6 bpm), P = 0.02. Similar norepinephrine release and more complete β1-blockade is observed in well-matched subjects with chronic heart failure treated with a mean daily dose of metoprolol XL 96.4 mg compared with carvedilol 32.9 mg.
Original language | English (US) |
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Pages (from-to) | 51-57 |
Number of pages | 7 |
Journal | Journal of Cardiovascular Pharmacology and Therapeutics |
Volume | 13 |
Issue number | 1 |
DOIs | |
State | Published - Mar 2008 |
Externally published | Yes |
Keywords
- Carvedilol
- Heart failure
- Heart rate
- Metoprolol
- Neurohormonal
- Norepinephrine
ASJC Scopus subject areas
- Pharmacology
- Cardiology and Cardiovascular Medicine
- Pharmacology (medical)