Impact of Carvedilol on the Serum Lipid Profile

Sharp, Randall P; Sirajuddin, Riaz; Sharief, Imran

doi:10.1345/aph.1k447

Cited by 13 publications

(7 citation statements)

References 17 publications

(4 reference statements)

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“…8,9 A recent review showed that carvedilol did not adversely affect plasma lipids compared to β1-selective agents. 33 The results of the main study from which these samples were tested have been published and are concordant with previous findings 17 . In our investigation, we found a treatment interaction with the Arg16Gly polymorphism and β-blocker therapy on changes in triglycerides levels, showing increased triglycerides with metoprolol when participants carried the Arg16Arg genotype.…”

Section: Discussionsupporting

confidence: 88%

β-AR Polymorphisms and Glycemic and Lipid Parameters in Hypertensive Individuals Receiving Carvedilol or Metoprolol

Vardeny¹,

Nicholas²,

Andrei³

et al. 2012

Am J Hypertens

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Background β-blocker therapy and β-adrenergic receptor (β-AR) polymorphisms are associated with increases in glucose and lipid levels. We investigated associations of common β1 and β2- AR single nucleotide polymorphisms (SNPs) with metabolic and lipid variables, and examined interactions with β-blocker treatment assignment to affect these parameters. Methods This was a Post hoc analysis of a double-blinded clinical trial of non-diabetic, hypertensive individuals that were randomized to receive carvedilol or metoprolol succinate. Fasting glucose, insulin, and lipid levels were measured at baseline, 3, and after 6 months. Genotypes for β1-AR SNPs Ser49Gly & Gly389Arg and β2-AR Arg16Gly & Gln27Glu were determined. Multivariable mixed models were used to examine associations between β-AR polymorphisms, metabolic parameters, and SNP interactions with β-blocker therapy (pinteraction). Results The 322 subjects were mean (standard deviation) 51.5 (11.2) years old. After 6 months, insulin levels increased by 35.6% on metoprolol but decreased by 9.9% on carvedilol (p=0.015). In univariate models, the Gln27Gln genotype had higher overall insulin levels with β-blockade compared to the Glu27Glu genotype (p=0.006). Both Arg16Gly (p=0.012) and Gln27Glu (p=0.037) SNPs were associated with triglycerides levels. An interaction between the Arg16Gly SNP and treatment was identified (pint=0.048). Conclusions These data suggest that insulin and triglycerides may be influenced by β2-AR polymorphisms in patients taking β–blockers.

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Section: Discussionsupporting

confidence: 88%

β-AR Polymorphisms and Glycemic and Lipid Parameters in Hypertensive Individuals Receiving Carvedilol or Metoprolol

Vardeny¹,

Nicholas²,

Andrei³

et al. 2012

Am J Hypertens

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“…It is possible that the beneficial vasodilatory effects mediated via nitric oxide may contribute to the clinical findings with nebivolol and carvedilol. Improvements in endothelial effects have also been hypothesized to contribute to the apparently improved adverse event profileparticularly related to metabolic effects and sexual dysfunction -of vasodilating beta-blockers compared with older agents in this class [62][63][64][65][66]. For example, a recent study [67] showed that nebivolol, but not metoprolol, improved the endothelial function of the corpus cavernosum in apolipoprotein E-knockout mice.…”

Section: Clinical Implications and Future Issuesmentioning

confidence: 99%

What is the role, if any, for beta-blockers as initial therapy for uncomplicated hypertension?

Pedersen

Cockcroft²

2009

Current Opinion in Cardiology

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The majority of evidence suggesting that beta-blockade should not be used in uncomplicated hypertension comes from studies using atenolol. It would therefore be premature and unwise to eliminate all beta-blockers from the array of agents available to optimize BP control in patients with uncomplicated hypertension by extrapolating data based almost entirely on the conventional beta-blocker atenolol. Vasodilating beta-blockers have beneficial effects on central BP, arterial stiffening, and nitric oxide-dependent endothelial dysfunction that may contribute to their clinical benefits in patients with hypertension.

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“…A post hoc analysis of the Glycemic Effects in Diabetes Mellitus: CarvedilolMetoprolol Comparison in Hypertensives (GEMINI) trial showed favorable lipid effects of carvedilol compared to metoprolol in over 1200 subjects with diabetes [9]. Sharp et al [10] analyzed 12 carvedilol studies, 6 of which compared carvedilol with selective beta 1-adrenergic antagonists and found that carvedilol had either a neutral or a mild beneficial effect on serum lipids. This difference may be due to the alpha 1-antagonist action as alpha-adrenergic blockers such as prazosin have been consistently shown to reduce serum triglycerides and increase HDL cholesterol [2,11,12].…”

Section: Beta-adrenergic Blockersmentioning

confidence: 99%

Drug-Induced Dyslipidemia

Simha

2015

Dyslipidemias

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Impact of Carvedilol on the Serum Lipid Profile

Cited by 13 publications

References 17 publications

β-AR Polymorphisms and Glycemic and Lipid Parameters in Hypertensive Individuals Receiving Carvedilol or Metoprolol

β-AR Polymorphisms and Glycemic and Lipid Parameters in Hypertensive Individuals Receiving Carvedilol or Metoprolol

What is the role, if any, for beta-blockers as initial therapy for uncomplicated hypertension?

Drug-Induced Dyslipidemia

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