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
-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
1-blocking properties.
Key words Dyslipidaemia - Hypertension - Captopril - Carvedilol - lipids - diet