Metabolic effects of carvedilol vs. metoprolol in patients with type 2 diabetes mellitus and hypertension: A randomized controlled trial

Abstract

DATA FROM LARGE OUTCOME trials indicate that the level of glycemic control predicts cardiovascular events. In the UK Prospective Diabetes Study (UKPDS), patients with lower initial glycemia had fewer adverse clinical outcomes despite similar glycemic progression. Taken together with data from the National Health and Nutrition Examination Survey IV (NHANES IV), that only 37% of adults with diabetes mellitus (DM) attain recommended levels of glycosylated hemoglobin (HbA1c), achieving better glycemic control should further reduce the risk of cardiovascular events. Randomized trials comparing reninangiotensin system (RAS) blockers with -blockers demonstrate that cardiovascular outcomes are improved by RAS blockers, which maintain or improve Author Affiliations, Financial Disclosures, and the list ofGEMINI Investigatorsare listedat theendof thisarticle. Corresponding Author: David S. H. Bell, MD, University of Alabama, Room 702, Faculty Office Tower 510, 20th St S, Birmingham, AL 35294 (dshbell @uab.edu). Context -Blockers have been shown to decrease cardiovascular risk in patients with hypertension and type 2 diabetes mellitus (DM); however, some components of the metabolic syndrome are worsened by some -blockers.