Haemodynamic effects of acute and chronic administration of low-dose carvedilol, a vasodilating β-blocker, in patients with cirrhosis and portal hypertension
Version of Record online: 4 MAR 2002
Alimentary Pharmacology & Therapeutics
Volume 16, Issue 3, pages 373–380, March 2002
How to Cite
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 & Therapeutics, 16: 373–380. doi: 10.1046/j.1365-2036.2002.01190.x
- Issue online: 4 MAR 2002
- Version of Record online: 4 MAR 2002
Carvedilol is a non-selective vasodilating β-blocker with weak α1 receptor antagonism. Recent studies have demonstrated its potential as a portal hypotensive agent.
To assess the haemodynamic effects and patient tolerability of the acute and chronic administration of low-dose carvedilol.
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.
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.
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.