β-blockers in hypertension: is carvedilol different?

Most studies assessing the effects of β-blockers were carried out with traditional, β1-selective β-blockers, such as metoprolol and atenolol. Pathophysiologic and pharmacologic studies have documented that not all β-blockers are created equal. In particular, the pharmacologic and clinical profiles of the newer, vasodilating β-blockers, such as carvedilol, have been shown to differ from those of the traditional β-blockers. These differences, although relevant in the younger patient with hypertension, are particularly important in elderly patients in whom traditional β-blockers may not be as effective or as well tolerated as the newer vasodilating agents.