Key result
Highly selective beta-1 blockers reduce mortality in hypertension, HF, and diabetes without worsening metabolism.
Why the study?
Sympathetic hyperactivation is a key feature of arterial hypertension, type 2 diabetes, and obesity, and the effects of beta-blockers in these populations require clarification.
Do beta-blockers reduce mortality and maintain metabolic safety in patients with impaired carbohydrate metabolism, hypertension, and heart failure?
Do beta-blockers reduce mortality and maintain metabolic safety in patients with impaired carbohydrate metabolism, hypertension, and heart failure?
Answers are grounded in this paper and cite their sources.
Beta-blockers, particularly highly selective β1-blockers like bisoprolol, are effective in reducing mortality and are metabolically safe in patients with diabetes, obesity, hypertension, and heart failure.
Clinical studies have shown that sympathetic hyperactivation (sympathetic overdrive) is one of the main features of arterial hypertension, type 2 diabetes, and obesity, which are often found simultaneously.The landmark British Prospective Diabetes Study (UKPDS), which lasted 20 years, showed that beta-blockers reduce any-cause mortality by 23 % in patients with young and middle-aged hypertension, overweight or obese with diabetes 2 type. The researchers concluded that the advantage of long-term use of BB in this study is due to the fact that in a population of patients with obesity, diabetes mellitus, hypertension and an extremely high level of activity of the sympathetic system of β1-blockade is especially effective.An analysis of subsequent large-scale clinical trials of the effectiveness of beta-blockers (in particular, bisoprolol in CIBIS II) showed that in patients with heart failure and diabetes, these drugs reduce overall mortality by 16 %.The safety study of the use of bisoprolol in effective therapeutic doses in patients with type 2 diabetes mellitus and hypertension did not reveal a statistically significant negative effect of this highly selective β1-blocker on carbohydrate and lipid metabolism.
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M. М. Ordyan (2020) conducted a review in Impaired carbohydrate metabolism, type 2 diabetes, obesity, arterial hypertension. Beta-blockers (highly selective beta-1 blockers, e.g., bisoprolol) was evaluated.
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