COMPARISON OF THE METABOLIC EFFECTS OF CARVEDILOL AND METОPROLOL IN HYPERTENSIVE PATIENTS WITH OVERWEIGHT AND OBESITY. THE CAMELLIA TRIAL

Aim. To compare two therapies based on carvedilol or metoprolol in hypertensive patients with overweight and obesity.Material and methods. 320 patients with arterial hypertension (1-2 degree) were involved in the study. 160 patients received carvedilol and 160 patients – metoprolol. Both randomized groups were comparable on the main clinical characteristics.Results. By the end of the study both systolic and diastolic blood pressure (SBP, DBP) reduced in both groups р&lt;0,0001. There were not differences of antihypertensive effect between investigated drugs (р=0,88 for SBP and р=0,61 for DBP). By the end of the study body mass index decreased by 0,52±0,10 kg/m2 (р&lt;0,0001) in carvedilol group and by 0,26±0,10kg/m2 (р&lt;0,01) in metoprolol group. Carvedilol in comparison with metoprolol had more positive effects on glucose (р&lt;0,01) and lipid blood levels. By the end of the study urine acid blood level reduction was observed in carvedilol group (-16,6 μmol/l) while an increasing tendency - in metoprolol group. Carvedilol did not have negative effect on serum potassium and creatinine levels. Adverse effects rate was 6,3% in carvedilol group and 3,8% - in metoprolol group.Conclusion. The results of open, randomized CAMELLIA trial confirmed antihypertensive effect and good tolerability of carvedilol in common clinical practice as well as demonstrated some its advantages in patients with metabolic syndrome. Carvedilol has positive metabolic effects on lipid, glucose and uric acid levels. Carvedilol therapy is more preferable in patients with arterial hypertension and metabolic risk factors.</p

COMPARISON OF THERAPIES BASED ON CARVEDILOL AND METOPROLOL IN HYPERTENSIVE PATIENTS WITH OVERWEIGHT OR OBESITY. THE FIRST RESULTS OF CAMELLIA TRIAL

Aim. To evaluate antihypertensive and metabolic effects of the therapy based on carvedilol (C) in comparison with metoprolol (M) in hypertensive patients with overweight or obesity.Material and methods. 320 patients were involved in multicenter, randomized open parallel study. One part of the patients received C 12,5 mg BID (Vedicardol, “Sintez”), another part – M 25 mg/day BID. Doubling dose of β-blockers (BB) and switching patients to combined therapy with AML 5-10 mg OD (Amlorus, “Sintez”) and hydrochlorothiazide (HCT) 12,5-25 mg OD was performed if necessary. The study duration was 24 weeks.Results. Significant reduction of systolic and diastolic blood pressure was revealed in both groups, there was no difference between groups (р=0,88 and p=0,61 respectively). Switching patients to combined therapy with AML and HCT was made more often in M group than in C group (p&gt;0,05). Prescription of BB resulted in significant reduction of the heart rate, there was no difference between groups (p=0,61). 96,2% patients of group C and 95,5% of group M reached target levels of BP. Significant reduction of glucose (p&lt;0,01) and uric acid levels were registered in group C as well as tendency to lowering of total cholesterol (TC) and low density lipoprotein cholesterol (LDLC) levels. 34 adverse effects were registered during observation period: 24 in group C and 10 in group M (p&gt;0.05), half of them were not related to BB taking.Conclusion: Controlled antihypertensive therapy, based on С and M, allows reaching target levels of BP in majority of patients with overweight or obesity. Switching to combined therapy was made more seldom in group of С than in M group. Both drugs demonstrated metabolic neutrality, however significant lowering of glucose and uric acid levels and tendency to lowering of TC an LDLC levels was observed only in group С.</p