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QJM Advance Access originally published online on June 9, 2006
QJM 2006 99(7):431-436; doi:10.1093/qjmed/hcl059
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© The Author 2006. Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Review

Antihypertensive treatment with beta-blockers and the spectrum of glycaemic control

P.A. Sarafidis and G.L. Bakris

From the Hypertension/Clinical Research Center, Departments of Preventive and Internal Medicine, Rush University Medical Center, Chicago, USA

Address correspondence to Dr P.A. Sarafidis, Hypertension/Clinical Research Center, Department of Preventive Medicine, Rush University Medical Center, 1700 West Van Buren, Suite 470, Chicago, IL 60612, USA. email: psarafidis11{at}yahoo.gr

Hypertension and type 2 diabetes mellitus (DM) are major cardiovascular risk factors, and often cluster in the same individual in the context of the metabolic syndrome. Management of hypertension in the diabetic patient is extremely important, and agents from all major antihypertensive classes are effective towards this goal. Conventional ß-blockers are associated with detrimental effects on insulin sensitivity, glycaemic control, and the incidence of type 2 DM and thus are less often used in hypertensive patients with DM. In contrast, the newer vasodilating ß-blockers appear to be free of adverse effects on the above metabolic parameters, and could be a valuable tool for hypertension treatment in patients with DM or the metabolic syndrome. This review summarizes the evidence on the effects of antihypertensive treatment with both traditional and vasodilating ß-blockers on parameters related to carbohydrate metabolism, and discuss the pathophysiological mechanisms that may be responsible.


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