A 62-year-old man with NYHA class III heart failure (LVEF 30%) on furosemide and lisinopril remains symptomatic. Carvedilol is added. Which pharmacological property of carvedilol, beyond beta-blockade, contributes to its mortality benefit in heart failure?
- A Angiotensin-converting enzyme inhibition
- B Potassium channel opening causing hyperpolarization
- C Alpha-1 receptor blockade causing vasodilation ✓
- D Calcium channel blockade reducing afterload
Correct answer: C. Alpha-1 receptor blockade causing vasodilation
Explanation
Carvedilol is a non-selective beta-blocker with additional alpha-1 receptor blockade, producing vasodilation and reducing afterload. This combined action, along with antioxidant properties, differentiates it from metoprolol and bisoprolol and contributes to mortality reduction in HFrEF. Beta-blockers without alpha-blockade (metoprolol succinate, bisoprolol) are also evidence-based, but carvedilol's vasodilatory profile is unique among them.
Reference: Goodman and Gilman's The Pharmacological Basis of Therapeutics, 14th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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