Carvedilol versus Cardioselective β-Blockers for the Treatment of Hypertension in Patients with Type 2 Diabetes Mellitus
Article first published online: 6 JAN 2012
2006 Pharmacotherapy Publications Inc.
Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy
Volume 26, Issue 10, pages 1491–1500, October 2006
How to Cite
Fardoun, R. Z. (2006), Carvedilol versus Cardioselective β-Blockers for the Treatment of Hypertension in Patients with Type 2 Diabetes Mellitus. Pharmacotherapy, 26: 1491–1500. doi: 10.1592/phco.26.10.1491
- Issue published online: 6 JAN 2012
- Article first published online: 6 JAN 2012
- type 2 diabetes mellitus;
- metabolic syndrome;
- cardiovascular risk
Treatment with β-blockers is recommended to achieve and maintain adequate blood pressure control in patients with hypertension, and these agents have been shown to decrease cardiovascular risk factors in patients with both hypertension and type 2 diabetes mellitus. However, β-blocker therapy also may worsen glycemic and lipidemic control and may lead to microalbuminuria. A recent study showed a better metabolic profile with carvedilol than with metoprolol in patients with both type 2 diabetes and hypertension in the presence of renin-angiotensin system blockade. This beneficial effect on metabolic components has been proposed as attributable to carvedilol's α-blocking effects or antioxidant properties. In this article, the pathophysiology of hypertension and type 2 diabetes and the association between them are reviewed, the pharmacologic properties of carvedilol are discussed, and clinical studies in the literature comparing carvedilol with selective β-blockers in patients with both type 2 diabetes and hypertension are identified and evaluated. This information should be useful to practitioners when selecting the optimum β-blocker for treating hypertension in patients with type 2 diabetes.