Trial reportJournal of diabetes and its complications
Beta-blockers have a beneficial effect upon endothelial function and microalbuminuria in African-American subjects with diabetes and hypertension.
Trial report in Journal of diabetes and its complications. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed, 35 citations in OpenAlex.
- Metoprolol compared to carvedilol deteriorates insulin-stimulated endothelial function in patients with type 2 diabetes - a randomized study.Cardiovascular diabetology · 2010Trial
- Comparative Evaluation of Captopril, Spironolactone, and Carvedilol Effect on Endothelial Function in Breast Cancer Women Undergoing Chemotherapy.Advanced biomedical research · 2023Article
- Long-term impact of spironolactone compliance on microalbuminuria in patients with primary aldosteronism.Hypertension research : official journal of the Japanese Society of Hypertension · 2021Article
- The current status of beta blockers' use in the management of hypertension.Saudi medical journal · 2014Review
- Carvedilol ameliorates early diabetic nephropathy in streptozotocin-induced diabetic rats.BioMed research international · 2014Article
- Beta blocker use in subjects with type 2 diabetes mellitus and systolic heart failure does not worsen glycaemic control.Cardiovascular diabetology · 2012Article
- Mechanism of testicular protection of carvedilol in streptozotocin-induced diabetic rats.Indian journal of pharmacologyArticle
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Authors and funding
5 authors at 4 institutions in 2 countries.
Funding
Abstract
backgroundType 2 diabetes mellitus (T2DM) with microalbuminuria (MA) is associated with increased risk of cardiovascular events (CVE) that may be attenuated by angiotensin-converting enzyme inhibitors (ACEIs), unless microalbuminuria persists (PMA). African-Americans (AA) have a higher prevalence of nephropathy with suboptimal response to ACEIs. We studied the effects of beta-blockers addition and comparative effects of carvedilol with metoprolol on 24-h urinary-albumin excretion (UAE) and endothelial function (EF) in AA with PMA.
methodsThirty-four AA 30-70 years of age with T2DM and PMA despite ACEI therapy were randomized to receive carvedilol or metoprolol in addition to ACEI and any other concurrent therapy. Carvedilol/metoprolol dose was titrated to achieve blood pressure (BP) <130/80 mm Hg. UAE and brachial-artery reactivity were studied at baseline and 12 weeks. We analyzed the effects of addition of beta-blockers and whether there was any difference in response between the two beta-blockers.
resultsThirty-three subjects completed the study; BP decreased to <135/80 mm Hg. After 12 weeks, beta-blocker treatment resulted in significant increase in flow-mediated dilatation (FMD) from 3.5+/-1% to 8.5+/-1% (P=.004) and significant reduction in mean log-transformed UAE from 2.655 g/g Cr+/-0.087 to 2.533 g/g Cr+/-0.093 (P=.028). FMD increased by 240% (P=.033) with carvedilol and by 110% (P=.096; NS) with metoprolol. UAE decreased with carvedilol by 0.35 g/g Cr (P=.023) and with metoprolol by 0.23 g/g Cr (P=.298; NS).
conclusionOur results clearly indicate that addition of beta-blockers to ACEI improves EF and reduces UAE in high-risk AA T2DM patients with PMA. Carvedilol but not metoprolol improves EF and reduces UAE in AA with identical BP control. Larger trials are needed to further elucidate the differential effects of carvedilol/metoprolol on EF and UAE and its impact on CVE in such patients.
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