Objective To systematically review the effectiveness and safety of carvedilol and metoprolol for primary hypertension.
Methods Such databases as PubMed, EMbase, Web of Science, The Cochrane Library, CBM, CNKI, VIP and WanFang Data were electronically searched for relevant studies from inception to December, 2012. Two reviewers independently screened literature according to the inclusion and exclusion criteria as well as the methods recommended by the Cochrane Collaboration, extracted data, and assessed the methodological quality of the included studies. Then, meta-analysis was performed using RevMan 5.1 software.
Results 7 trials involving 2 243 patients were included. The results of meta-analysis showed no significant difference in the reduction of systolic blood pressure, diastolic blood pressure, and heart rate between the carvedilol and metoprolol groups (P gt;0.05). However, the carvedilol group was superior to the metoprolol group in improving serum triglyceride (MD=0.75, 95%CI 0.45 to 1.04, P lt;0.000 01), serum cholesterol (MD=0.38, 95%CI 0.19 to 0.56, P lt;0.000 1), serum low density lipoprotein (MD=0.59, 95%CI 0.33 to 0.85, P lt;0.000 01), serum high density lipoprotein (MD= –0.09, 95%CI –0.16 to –0.02, P=0.008), and fasting plasma glucose (MD=0.36, 95%CI 0.21 to 0.51, P lt;0.000 01). In addition, the incidence of drug related adverse reaction was significantly lower in the carvedilol group (OR=0.39, 95%CI 0.24 to 0.63, P=0.000 1).
Conclusion Based on current evidence, carvedilol tends to have beneficial effects on metabolic parameters and safety profiles, compared with metoprolol.
Citation： NIU Xiaowei,XU Han,HE Shengliang,CHEN De,YAN Dong,HE Zhiyu,YAO Yali. Carvedilol versus Metoprolol for Primary Hypertension: A Systematic Review. Chinese Journal of Evidence-Based Medicine, 2013, 13(8): 963-970. doi: 10.7507/1672-2531.20130168 Copy