Pepine 200329 (INVEST), Van Dijk 198825, Kawanishi 199227, Savonitto 199628 (IMAGE): Evidence from 4 RCT’s shows that there were significantly fewer anginal episodes/week [MD 0.11 (0.07 to 0.15)] with CCB (verapamil, diltiazem, nifedipine) compared with BB (atenolol, metoprolol, propranolol) (follow-up 6 weeks–2.7 years). However, they are very rarely used to treat these conditions now because there are other medicines that are thought to work better. Now evidence from a huge study of almost 20,000 people has learned that beta blockers are dangerous to anyone with any blood sugar abnormality. They are known to shield against future heart attacks in people who just had one and can be helpful in certain types of heart failure. Tilt your head back, gaze upward and pull down the lower eyelid to make a pouch. My mail suggests that American doctors are not aware of the negative impact of beta blockers on the blood sugar of their patients as many people with Type 2 who contact me are taking these drugs. In short, the beta-blockers interfere with the “fight-or-flight” response of the body to stress or panic.
Many people also need a combination of two or more different treatments for hypertension in order to reach their target blood pressure level. This result could possibly have been biased by different baseline HbA1c levels between the two groups and therefore does not provide absolute evidence for the differential effects on glycaemic control between carvedilol and bisoprolol. As with all beta-blockers, sudden withdrawal can trigger rebound hypertension. Patients with a personal or family history of depression had significantly higher scores on depression scales than those without such histories. As adherence to treatment was not available it is possible that those older or sicker could not take the BB as prescribed. This study is the first to address the QTc interval and QTc dispersion in Type 1 diabetic patients treated with metoprolol. Many conventional doctors will prescribe a beta blocker, a statin, and an oral hypoglycemic agent at the same time.
80 (4): 365–9.