title: Risk of new-onset diabetes mellitus associated with beta-blocker treatment for hypertension.
abstract: BACKGROUND
  This study investigated the risk of new-onset diabetes (NOD) among hypertensive patients initiating carvedilol therapy vs other beta-blocker (BB) therapy in a clinical practice setting.
  
  
  METHODS
  Patients aged ≥18 years with ≥1 pharmacy claim for a BB of interest (carvedilol immediate-release [IR]/controlled-release [CR], atenolol, metoprolol succinate, or metoprolol tartrate) were identified in the IMS LifeLink Health Plan Claims Database. Index date was the first chronologically occurring prescription for any BB during the enrollment period (July 1, 2000-December 31, 2007). Patients had to be continuously eligible to receive healthcare services 6 months prior to and a minimum of 3 months after index date and have ≥1 diagnostic code for hypertension (ICD-9-CM: 401.xx-405.xx) during this time frame. Patients were excluded for having a diagnosis of diabetes mellitus (ICD-9-CM: 250.xx) and/or prescription for antidiabetic therapy in the 6 months prior to and/or 3 months after index date. Eligible patients were propensity-score matched in a 1:3 ratio (carvedilol : other BBs). Mean duration of follow-up was 12.8 and 14.8 months for the carvedilol group and other BB group, respectively. Primary outcome of interest was presence and timing of NOD.
  
  
  RESULTS
  Among 3084 patients in the carvedilol group and 9252 in the other BB group, mean age was 56 years, with 54% male. NOD rate was 3.16 per 100 person-years for carvedilol patients vs 3.36 for patients in the other BB group (NS). Risk of NOD was similar between groups (HR 0.971, 95% CI: 0.78, 1.21; P = 0.792).
  
  
  CONCLUSIONS
  Findings suggest the risk of NOD among hypertensive patients is similar between carvedilol and other BB agents (i.e., atenolol, metoprolol succinate, or metoprolol tartrate).
  
  
  CONCLUSIONS
  The use of administrative claims data and relatively short follow-up period may limit the generalizability of results.
authors.affiliation: Tulane University Health Sciences Center, New Orleans, LA, USA.
authors.forename: Vivian
authors.initials: V
authors.lastname: Fonseca
authors.forename: Puza P
authors.initials: PP
authors.lastname: Sharma
authors.forename: Manan
authors.initials: M
authors.lastname: Shah
authors.forename: Prakash
authors.initials: P
authors.lastname: Deedwania
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000009:adverse effects* / Q000627:therapeutic use*; D000328:Adult; D017668:Age of Onset; D000368:Aged; D000959:Antihypertensive Agents / Q000009:adverse effects / Q000627:therapeutic use; D002227:Carbazoles / Q000009:adverse effects / Q000627:therapeutic use; D000077261:Carvedilol; D015331:Cohort Studies; D003920:Diabetes Mellitus / Q000139:chemically induced* / Q000453:epidemiology / Q000209:etiology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011412:Propanolamines / Q000009:adverse effects / Q000627:therapeutic use; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D000319:Adrenergic beta-Antagonists; D000959:Antihypertensive Agents; D002227:Carbazoles; D011412:Propanolamines; D000077261:Carvedilol