Beta-blockers in the management of hypertension in patients with type 2 diabetes mellitus: is there a role?

Drugs
F DunneU Martin

Abstract

It has been conclusively established that treatment of hypertension in patients with type 2 (non-insulin-dependent) diabetes mellitus will significantly reduce the incidence of stroke, heart failure and progression of diabetic complications. Beta-blockers are effective antihypertensive agents which, in long term studies, have proven beneficial in reducing important clinical end-points. However nonselective beta-blockers may have a negative effect on lipid profiles and contribute to hypoglycaemic unawareness, thus preventing their use in some patients with diabetes mellitus. The development of newer and more selective beta-blockers has overcome many of these problems. In addition, some of the newer agents have novel properties such as release of nitric oxide, which theoretically would make them more attractive in patients with diabetes mellitus. Overall, the adverse metabolic effects of beta-blockers do not appear to be important in clinical practice and these agents should no longer be contraindicated in patients with type 2 diabetes mellitus. Their proven cardiovascular benefits would seem to easily tip the balance in favour of their use.

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Citations

Dec 4, 2003·Pharmacology & Therapeutics·Noboru Toda
Mar 21, 2006·Journal of the American College of Cardiology·Scott M Grundy
May 13, 2006·Medical Care Research and Review : MCRR·Jeff BeichIbrahim A Ibrahim
Sep 18, 2001·Drugs·F H Messerli, E Grossman

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