[Clinical and metabolic effects of cardioselective beta-adrenoblockers nebivolol and metoprolol in patients with hypertension and ischemic heart disease associated with type 2 diabetes].
OBJECTIVE
To compare efficacy and safety of cardioselective beta-adrenoblockers nebivolol and metoprolol in patients with hypertension and ischemic heart disease (IHD) combined with type 2 diabetes.


METHODS
Patients with IHD, class II-III angina and moderately severe compensated or subcompensated type II diabetes (n=35, 29 with grade 1-2 hypertension according to WHO 1999 classification) were divided into 2 groups with similar clinical and laboratory characteristics. Patients of group 1 received metoprolol (50-100 mg/day), of group 2--nebivolol (5-7.5 mg/day) for 8 weeks. Data of physical investigation, exercise tests, 24-hour blood pressure and heart rate monitoring, analysis of lipid spectrum and glycemic profile were used for assessment of treatment efficacy.


RESULTS
Decrease of number of anginal attacks and nitroglycerine requirement was more pronounced in nebivolol treated patients. The use of both drugs was associated with lowering of blood pressure and heart rate. There were no unfavorable changes of parameters of carbohydrate and lipid metabolism. Pronounced (by 19.2%) lowering of triglycerides was observed in nebivolol treated patients. Both drugs were well tolerated.


CONCLUSIONS
Nebivolol and metoprolol are effective and safe antianginal agents in patients with IHD and hypertension combined with type 2 diabetes. However in doses used nebivolol produced more favorable metabolic and hemodynamic effects.
Makolkin
V I
VI
Akhmedova
O O
OO
Buval'tsev
V I
VI
Gavrilov
Iu V
IuV
Petriĭ
V V
VV
D000319:Adrenergic beta-Antagonists / Q000008:administration & dosage / Q000627:therapeutic use*; D000787:Angina Pectoris / Q000150:complications / Q000188:drug therapy / Q000378:metabolism; D000959:Antihypertensive Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001578:Benzopyrans / Q000008:administration & dosage / Q000627:therapeutic use*; D050260:Carbohydrate Metabolism; D003627:Data Interpretation, Statistical; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000378:metabolism; D004983:Ethanolamines / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy* / Q000378:metabolism; D050356:Lipid Metabolism; D008297:Male; D008790:Metoprolol / Q000008:administration & dosage / Q000627:therapeutic use*; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000150:complications / Q000188:drug therapy* / Q000378:metabolism; D000068577:Nebivolol; D013997:Time Factors; D014280:Triglycerides / Q000097:blood
D000319:Adrenergic beta-Antagonists; D000959:Antihypertensive Agents; D001578:Benzopyrans; D004983:Ethanolamines; D014280:Triglycerides; D000068577:Nebivolol; D008790:Metoprolol