Is there a role for beta-blockers in hypertensive diabetic patients?
Clinical trials have not yet produced long-term primary prevention data on the effects of angiotensin converting enzyme inhibitors, calcium antagonists or alpha-blockers on cardiovascular complications and sudden death in hypertensive patients. Large-scale secondary preventive studies on calcium antagonists have been disappointing. In contrast, beta-blockers have an established role in cardioprotection both in primary and secondary preventive studies and there is evidence to show that the cardioprotective effect of beta-blockers is even greater in the diabetic population. Furthermore, this favourable impact of beta-blockers was achieved despite diabetic patients having a worse risk factor profile and poorer prognosis. In this review the use of beta-blockers in diabetic patients will be discussed and their impact on coronary artery disease described.
Tse
W Y
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Department of Nephrology, Queen Elizabeth Hospital, Edgbaston, Birmingham, UK.
Kendall
M
M
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D001786:Blood Glucose / Q000187:drug effects / Q000378:metabolism; D002121:Calcium Channel Blockers / Q000627:therapeutic use; D002316:Cardiotonic Agents / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D048909:Diabetes Complications; D003920:Diabetes Mellitus / Q000097:blood / Q000188:drug therapy; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy*; D007003:Hypoglycemia / Q000139:chemically induced; D007328:Insulin / Q000009:adverse effects; D013997:Time Factors
D000319:Adrenergic beta-Antagonists; D001786:Blood Glucose; D002121:Calcium Channel Blockers; D002316:Cardiotonic Agents; D007328:Insulin