Appropriate dose transition to a controlled-release formulation of carvedilol in patients with hypertension.

Few patients with hypertension meet recommended target blood pressure goals, and most hypertensive patients require at least 2 antihypertensive medications from different pharmacologic classes to adequately lower blood pressure. beta-Blockers are guideline-recommended for the treatment of hypertension with compelling indications. beta-Blockers differ with respect to pharmacology (particularly receptor biology and ancillary properties), hemodynamic effects, and tolerability. In clinical practice, the choice of beta-blockers for individual patients with hypertension is often based on practical issues such as convenience and cost. However, given the pharmacologic and clinical trial data demonstrating differences, the choice of beta-blocker for the treatment of high-risk hypertension should be evidence-based. Vasodilating beta-blockers, such as carvedilol, decrease blood pressure without the concerning hemodynamic, renal, and metabolic responses associated with most beta-blockers. The use of carvedilol CR (once daily) may be preferable to a twice-daily regimen.