Heart failure, also known as congestive heart failure, occurs when the heart muscle does not pump blood properly due to, among others, coronary artery disease, high blood pressure (hypertension), diabetes or obesity. This state gradually makes the heart too weak or stiff to fill and pump blood efficiently.

Hypertension and Heart Failure are silent killers with a high prevalence in Indonesia. The death rate for heart failure increases about 5-10% per year in cases of mild heart failure and 30-40% in cases of severe heart failure.

Hypertension can result in injury of the artery walls. The high pressure can create a small tear that turns into scar tissue. As a result, cholesterol, fat, and other things easily accumulate in the arteries. Untreated hypertension can cause narrowing and stiffening of blood vessels.

Over time, these things will reduce blood flow and blood supply and force the heart to work harder than normal. Overload of heart will cause enlargement of the heart and diminished efficiency of its function. Left untreated, the heart function will continue declining, resulting in heart failure.

Heart failure is characterized by symptoms of fatigue, shortness of breath and swelling of the legs and ankles, rapid or irregular heartbeat, persistent cough or wheezing with white or pink blood-tinged phlegm, swelling of abdomen (ascites), lack of appetite and nausea.

Doctor will recommend several types of drugs for heart failure :

  • Angiotensin-converting enzyme (ACE) inhibitors, examples include enalapril, lisinopril and captopril
  • Angiotensin II receptor blockers., which include losartan and valsartan
  • Beta blockers, examples include carvedilol, metoprolol and bisoprolol
  • Diuretics, such as furosemide and etc.

In class of drugs for beta blocker, Carvedilol not only slows heart rate and reduces blood pressure but also limits or reverses some of the damage heart if it has systolic heart failure. Other benefits include antioxidant effects, reduction in neutrophil infiltration, apoptosis inhibition, reduction of vascular smooth muscle migration, and improvement of myocardial remodeling post-acute myocardial infarction. Being that carvedilol can prevent the formation of oxidized low-density lipoproteins and inhibit vascular smooth muscle cell proliferation and migration, it shows a great promise in the treatment of atherosclerotic disease formation and progression.

This is the supporting reason of recommendation of using Carvedilol in the management of hypertension in patients with essential hypertension (increased blood pressure without an identifiable secondary cause), angina (chest pain due to insufficient blood flow to the heart muscle), and hypertension due to pregnancy or post-myocardial infarction (heart attack) as well as hypertension in patients with renal impairment.

Carvedilol is a relatively well-tolerated drug and appears to have less frequent adverse events include dizziness, lightheadedness, fatigue, headaches, diarrhea, weight gain, depression, impotence than with other beta-blockers and is dose-related. Carvedilol is one of anti-hypertension from Darya-Varia Laboratoria with brand name Carvilol

It is essential to have a good control of blood pressure specifically in long-term hypertension management, to avoid heart failure or other complications that may result in death.

Source from :

  1. https://www.mayoclinic.org/diseases-conditions/heart-failure/diagnosis-treatment/drc-20373148
  2. https://www.halodoc.com/artikel/awas-hipertensi-bisa-picu-gagal-jantung
  3. https://www.mayoclinic.org/diseases-conditions/heart-failure/symptoms-causes/syc-20373142
  4. E-Book : Carvedilol (StatPearls) https://www.ncbi.nlm.nih.gov/books/NBK534868/