From the Guidelines
Carvedilol (Coreg) does not typically cause hypertension; in fact, it is specifically prescribed to treat high blood pressure. Carvedilol is a beta-blocker that works by blocking certain natural chemicals in your body (such as epinephrine) that affect the heart and blood vessels, thereby reducing heart rate and blood pressure. According to the 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults 1, carvedilol is preferred in patients with heart failure with reduced ejection fraction (HFrEF).
However, if a patient suddenly stops taking carvedilol, they may experience rebound hypertension as a withdrawal effect. This is why it's essential to taper off the medication gradually under medical supervision rather than stopping abruptly, as stated in the guideline 1. Additionally, in rare cases, some patients might experience paradoxical reactions to medications, but hypertension would be an extremely unusual side effect of carvedilol. Common side effects include dizziness, fatigue, and lightheadedness due to the blood pressure-lowering effects.
If a patient taking carvedilol experiences high blood pressure, they should consult their healthcare provider as this likely indicates that the medication is not effectively controlling their underlying hypertension rather than being caused by the medication itself. The guideline also emphasizes the importance of avoiding abrupt cessation of carvedilol to prevent rebound hypertension 1.
Some key points to consider when prescribing carvedilol include:
- The usual dose range is 12.5-50 mg/day, taken twice daily 1
- Carvedilol is preferred in patients with HFrEF 1
- Avoid abrupt cessation to prevent rebound hypertension 1
- Monitor patients for common side effects such as dizziness, fatigue, and lightheadedness due to blood pressure-lowering effects.
From the Research
Can Coreg (Carvedilol) Cause Hypertension
- There is no direct evidence to suggest that Coreg (carvedilol) causes hypertension. In fact, studies have shown that carvedilol is effective in lowering blood pressure in patients with mild to moderate hypertension 2, 3, 4.
- Carvedilol is a beta-adrenoceptor antagonist that also causes peripheral vasodilation, which helps to reduce total peripheral resistance and lower blood pressure 3.
- The blood pressure lowering effect of carvedilol has been compared to other antihypertensive agents, and it has been found to be similar to or more effective than some traditional beta-blockers 2, 3, 5.
- Some studies have suggested that carvedilol may be particularly beneficial in certain populations, such as patients with renal impairment or those with metabolic syndrome or diabetes 3, 4.
- Overall, the evidence suggests that carvedilol is an effective antihypertensive agent that can help to lower blood pressure in patients with hypertension, rather than causing it 2, 3, 4, 6, 5.