Metoprolol compared to carvedilol deteriorates insulin-stimulated endothelial function in patients with type 2 diabetes - a randomized study

Kveiborg, Britt; Hermann, Thomas; Major‐Pedersen, Atheline; Christiansen, Buris; Rask‐Madsen, Christian; Raunsø, Jakob; Køber, Lars; Torp‐Pedersen, Christian; Domínguez, Helena

doi:10.1186/1475-2840-9-21

Cited by 29 publications

(21 citation statements)

References 36 publications

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“…These data coincide with Fonarow et al [55]; Fonseca [47]; Deedwania [56]; Gastone and Colin [57]. Carvedilol reduces peripheral vascular resistance, have little or no effect on cardiac output, and improve endothelial function through anti-oxidative and free radical scavenger properties [56].…”

Section: Discussionsupporting

confidence: 74%

“…Our data in the present study revealed a significant decrease in blood glucose level, serum insulin and a significant improvement in insulin sensitivity in carvedilol treated group in comparison to UHFD group. These data are in accordance with Wilson et al [44]; Stefania et al [45]; Kveiborg et al [46]; Fonseca, [47]. In contrast to our results Bakriset al [48] found that carvedilol did not affect glycemic control but improves some components of the metabolic syndrome relative to metoprolol in patients with DM and hypertension.…”

Section: Discussioncontrasting

confidence: 57%

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Effects of Combination of Carvedilol and Melatonin on Induced Metabolic Syndrome in Rats

Malak¹

2014

Biochem Physiol

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Background: The prevalence of metabolic syndrome is increasing and it is considered one of the main threats to human health worldwide. Fructose feeding induces hyper-insulinemia, insulin resistance and hyper-triglyceridemia. The main objective of the present study is to evaluate the pharmacological effects of the single and combined administration of carvedilol and melatonin on fructose-induced metabolic syndrome in rats.

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Section: Discussionsupporting

confidence: 74%

Section: Discussioncontrasting

confidence: 57%

Effects of Combination of Carvedilol and Melatonin on Induced Metabolic Syndrome in Rats

Malak¹

2014

Biochem Physiol

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“…Zhoa et al described vascular benefits of carvedilol through preservation of endothelial junctions, independent of β‐AR inhibition (Zhao, Yang, You, Cui, & Gao, 2007). Furthermore, specific comparison of metoprolol and carvedilol in patients with type 2 diabetes showed a detrimental effect of metoprolol on insulin‐stimulated endothelial function (Kveiborg et al, 2010). As vasodilation, particularly in skeletal muscle, is crucial to glucose disposal (Keske et al, 2017), carvedilol's ability to maintain or improve vascular function may lead to better glycemic control in patients with diabetes than other inhibitors selective for β1‐AR (Haas et al, 2003; Jacob & Henriksen, 2004).…”

Section: Discussionmentioning

confidence: 99%

Carvedilol and metoprolol are both able to preserve myocardial function in type 2 diabetes

et al. 2020

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Purpose Increasing cohorts of patients present with diabetic cardiomyopathy, and with no targeted options, treatment often rely on generic pharmaceuticals such as β‐blockers. β‐blocker efficacy is heterogenous, with second generation β‐blocker metoprolol selectively inhibiting β1‐AR, while third generation β‐blocker carvedilol has α1‐AR inhibition, antioxidant, and anti‐apoptotic actions alongside nonselective β‐AR inhibition. These additional properties have led to the hypothesis that carvedilol may improve cardiac contractility in the diabetic heart to a greater extent than metoprolol. The present study aimed to compare the efficacy of metoprolol and carvedilol on myocardial function in animal models and cardiac tissue from patients with type 2 diabetes and preserved ejection fraction. Methods Echocardiographic examination of cardiac function and assessment of myocardial function in isolated trabeculae was carried out in patients with and without diabetes undergoing coronary artery bypass grafting (CABG) who were prescribed metoprolol or carvedilol. Equivalent measures were undertaken in Zucker Diabetic Fatty (ZDF) rats following 4 weeks treatment with metoprolol or carvedilol. Results Patients receiving carvedilol compared to metoprolol had no difference in cardiac function, and no difference was apparent in myocardial function between β‐blockers. Both β‐blockers similarly improved myocardial function in diabetic ZDF rats treated for 4 weeks, without significantly affecting in vivo cardiac function. Conclusions Metoprolol and carvedilol were found to have no effect on cardiac function in type 2 diabetes with preserved ejection fraction, and were similarly effective in preventing myocardial dysfunction in ZDF rats.

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“…Moreover, the addition of carvedilol for BP control resulted in a significant decrease in triglyceride, total cholesterol, and non-high-density lipoprotein (HDL) cholesterol levels, whereas the use of metoprolol resulted in a significantly greater rate of initiation of statin therapy or an increase in the dose of existing statin therapy [33]. Finally, insulin-stimulated endothelial function was preserved during treatment with carvedilol whereas it was blunted during treatment with metoprolol [34]. However, although a favorable metabolic profile might be considered in selecting a specific β-blocker, these agents, both traditional and newer, have wellestablished indications in diabetes patients with a previous myocardial infarction, rhythm disorders, or heart failure because of their proven effectiveness in reducing mortality [28].…”

Section: Metabolic Effects Of Antihypertensive Drugs: What We Alreadymentioning

confidence: 94%

Optimal Therapy in Hypertensive Subjects with Diabetes Mellitus

Reboldi

Gentile

Angeli

et al. 2011

Curr Atheroscler Rep

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Diabetes and its micro- and macrovascular complications represent a worldwide epidemic that will place an enormous financial burden on poorer countries in the years to come. In patients with diabetes and hypertension, the main determinant of the cardiovascular and renal benefits of antihypertensive drugs is the blood pressure (BP) level achieved under treatment. Quite recently, the paradigm of a BP target < 130/80 mm Hg in these patients has been questioned by a number of trials, including data from the Action to Control Cardiovascular Risk in Diabetes (ACCORD) blood pressure-lowering arm and from the diabetic cohort of International Verapamil SR-Trandolapril Study (INVEST). At the same time, even if the key role of BP control is unquestionable, a growing number of published trials suggest that different antihypertensive combinations may offer specific cardio-, vasculo-, and renoprotective advantages that go beyond BP reduction per se. The present review focuses on the most recent and important literature that explored the "optimal" antihypertensive therapy in patients with type 2 diabetes and concomitant hypertension, and it discusses in detail the various areas of uncertainty, including the specific renoprotective effects of renin-angiotensin system blocking agents and the long-term effects of angiotensin-converting enzyme/angiotensin receptor blocker combinations on the progression of diabetic nephropathy.

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Metoprolol compared to carvedilol deteriorates insulin-stimulated endothelial function in patients with type 2 diabetes - a randomized study

Cited by 29 publications

References 36 publications

Effects of Combination of Carvedilol and Melatonin on Induced Metabolic Syndrome in Rats

Effects of Combination of Carvedilol and Melatonin on Induced Metabolic Syndrome in Rats

Carvedilol and metoprolol are both able to preserve myocardial function in type 2 diabetes

Optimal Therapy in Hypertensive Subjects with Diabetes Mellitus

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