Postural hypotension in elderly patients given carvedilol.

First dose postural hypotension is commonly observed with antihypertensive drugs,1,2 but its incidence may be overstated in clinical trials because of protocol requirements, which may include frequent venesection, fasting, acute withdrawal from caffeine, and frequent changes in posture.1 The s blocker vasodilator drug carvedilol is associated with orthostatic hypotension, particularly in elderly people.*RF 234* We assessed the incidence of first dose hypotension in the absence of possible confounding factors linked to protocol. The study group comprised 16 elderly patients (nine men; mean (SD) age 70 (6) mean weight 73 (17) kg) with uncomplicated mild or moderate hypertension whose supine diastolic blood pressures were 90-110 mm Hg after one week's washout with placebo after antihypertensive treatment. Previous studies showed that a sample of 10-18 subjects would produce an 80% chance of detecting a difference in response of 10 mm Hg between treatments at the …