Abstract
Background: Although β-blockers are known to increase newonset diabetes mellitus (DM), previous evidence have been controversial. It has been suggested that newer vasodilatory β-blockers yield better glycemic control than older nonselective agents. The aim of this study was to evaluate the diabetogenicity of currently used newer β-blockers based on β1 receptor selectivity in a series of Asian population. Methods: We investigated a total of 65,686 hypertensive patients without DM from 2004 to 2014. Patients with hemoglobin (Hb) A1c ≤6.0%, fasting blood glucose ≤110 mg/dL, and no history of diabetes or diabetic treatment were enrolled for analysis. Patients were divided into the β-blockers group and non-β-blockers group. Propensity score matching (PSM) analysis using a logistic regression model was performed to adjust for potential confounders. The primary end point was the cumulative incidence of new-onset DM, defined as a fasting blood glucose ≥126 mg/dL or HbA1c ≥6.5%, and major adverse cardiac and cerebral events (MACCE), defined as a composite of total death, nonfatal myocardial infarction, and cerebrovascular accidents. We investigated predictors of new-onset DM and MACCE based on 2 models, including clinical risk factors and co-medications, respectively. Results: Mean follow-up duration was 30.91 ± 23.14 months in the entire group before adjustment. The β-blockers group had a significantly higher incidence of new-onset DM and MACCE than the non-β-blockers group. After PSM, analysis of a total of 2284 patients (1142 pairs, C-statistic = 0.752) showed no difference between the 2 groups in new-onset DM or MACCE. In multivariate analysis after PSM, baseline HbA1c, stroke, heart failure, nonselective β-blockers, and age were independent predictors of new-onset DM. Selective β1-blockers did not increase new-onset DM after adjustment for other antihypertensive medication and statins. Conclusions: In the era of newer β-blockers, selective β1-blockers were not associated with new-onset DM. More evidence is needed to verify this relationship and the underlying mechanisms.
| Original language | English |
|---|---|
| Pages (from-to) | 38-45 |
| Number of pages | 8 |
| Journal | Journal of Cardiovascular Pharmacology |
| Volume | 71 |
| Issue number | 1 |
| DOIs | |
| Publication status | Published - 2018 Jan 1 |
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Keywords
- Bisoprolol
- Carvedilol
- Hypertension
- Newonset diabetes mellitus
- Nonselective β-blockers
- Selective β1-blockers
ASJC Scopus subject areas
- Pharmacology
- Cardiology and Cardiovascular Medicine
Cite this
Selective ß1-blockers are not associated with new-onset diabetes mellitus in hypertensive patients. / Park, Yoonjee; Choi, Byoung Geol; Rha, Seung-Woon; Baek, Man Jong; Ryu, Yang Gi; Choi, Se Yeon; Byun, Jae Kyeong; Shim, Min Suk; Mashaly, Ahmed; Li, Hu; Jang, Won Young; Kim, Woohyeun; Kang, Jun Hyuk; Choi, Jah Yeon; Park, Eun Jin; Park, Sung Hun; Lee, Sunki; Na, Jin Oh; Choi, Cheol Ung; Lim, Hong Euy; Kim, Eung Ju; Park, Chang Gyu; Seo, Hong Seog; Oh, Dong Joo.
In: Journal of Cardiovascular Pharmacology, Vol. 71, No. 1, 01.01.2018, p. 38-45.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Selective ß1-blockers are not associated with new-onset diabetes mellitus in hypertensive patients
AU - Park, Yoonjee
AU - Choi, Byoung Geol
AU - Rha, Seung-Woon
AU - Baek, Man Jong
AU - Ryu, Yang Gi
AU - Choi, Se Yeon
AU - Byun, Jae Kyeong
AU - Shim, Min Suk
AU - Mashaly, Ahmed
AU - Li, Hu
AU - Jang, Won Young
AU - Kim, Woohyeun
AU - Kang, Jun Hyuk
AU - Choi, Jah Yeon
AU - Park, Eun Jin
AU - Park, Sung Hun
AU - Lee, Sunki
AU - Na, Jin Oh
AU - Choi, Cheol Ung
AU - Lim, Hong Euy
AU - Kim, Eung Ju
AU - Park, Chang Gyu
AU - Seo, Hong Seog
AU - Oh, Dong Joo
PY - 2018/1/1
Y1 - 2018/1/1
N2 - Background: Although β-blockers are known to increase newonset diabetes mellitus (DM), previous evidence have been controversial. It has been suggested that newer vasodilatory β-blockers yield better glycemic control than older nonselective agents. The aim of this study was to evaluate the diabetogenicity of currently used newer β-blockers based on β1 receptor selectivity in a series of Asian population. Methods: We investigated a total of 65,686 hypertensive patients without DM from 2004 to 2014. Patients with hemoglobin (Hb) A1c ≤6.0%, fasting blood glucose ≤110 mg/dL, and no history of diabetes or diabetic treatment were enrolled for analysis. Patients were divided into the β-blockers group and non-β-blockers group. Propensity score matching (PSM) analysis using a logistic regression model was performed to adjust for potential confounders. The primary end point was the cumulative incidence of new-onset DM, defined as a fasting blood glucose ≥126 mg/dL or HbA1c ≥6.5%, and major adverse cardiac and cerebral events (MACCE), defined as a composite of total death, nonfatal myocardial infarction, and cerebrovascular accidents. We investigated predictors of new-onset DM and MACCE based on 2 models, including clinical risk factors and co-medications, respectively. Results: Mean follow-up duration was 30.91 ± 23.14 months in the entire group before adjustment. The β-blockers group had a significantly higher incidence of new-onset DM and MACCE than the non-β-blockers group. After PSM, analysis of a total of 2284 patients (1142 pairs, C-statistic = 0.752) showed no difference between the 2 groups in new-onset DM or MACCE. In multivariate analysis after PSM, baseline HbA1c, stroke, heart failure, nonselective β-blockers, and age were independent predictors of new-onset DM. Selective β1-blockers did not increase new-onset DM after adjustment for other antihypertensive medication and statins. Conclusions: In the era of newer β-blockers, selective β1-blockers were not associated with new-onset DM. More evidence is needed to verify this relationship and the underlying mechanisms.
AB - Background: Although β-blockers are known to increase newonset diabetes mellitus (DM), previous evidence have been controversial. It has been suggested that newer vasodilatory β-blockers yield better glycemic control than older nonselective agents. The aim of this study was to evaluate the diabetogenicity of currently used newer β-blockers based on β1 receptor selectivity in a series of Asian population. Methods: We investigated a total of 65,686 hypertensive patients without DM from 2004 to 2014. Patients with hemoglobin (Hb) A1c ≤6.0%, fasting blood glucose ≤110 mg/dL, and no history of diabetes or diabetic treatment were enrolled for analysis. Patients were divided into the β-blockers group and non-β-blockers group. Propensity score matching (PSM) analysis using a logistic regression model was performed to adjust for potential confounders. The primary end point was the cumulative incidence of new-onset DM, defined as a fasting blood glucose ≥126 mg/dL or HbA1c ≥6.5%, and major adverse cardiac and cerebral events (MACCE), defined as a composite of total death, nonfatal myocardial infarction, and cerebrovascular accidents. We investigated predictors of new-onset DM and MACCE based on 2 models, including clinical risk factors and co-medications, respectively. Results: Mean follow-up duration was 30.91 ± 23.14 months in the entire group before adjustment. The β-blockers group had a significantly higher incidence of new-onset DM and MACCE than the non-β-blockers group. After PSM, analysis of a total of 2284 patients (1142 pairs, C-statistic = 0.752) showed no difference between the 2 groups in new-onset DM or MACCE. In multivariate analysis after PSM, baseline HbA1c, stroke, heart failure, nonselective β-blockers, and age were independent predictors of new-onset DM. Selective β1-blockers did not increase new-onset DM after adjustment for other antihypertensive medication and statins. Conclusions: In the era of newer β-blockers, selective β1-blockers were not associated with new-onset DM. More evidence is needed to verify this relationship and the underlying mechanisms.
KW - Bisoprolol
KW - Carvedilol
KW - Hypertension
KW - Newonset diabetes mellitus
KW - Nonselective β-blockers
KW - Selective β1-blockers
UR - http://www.scopus.com/inward/record.url?scp=85042715841&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85042715841&partnerID=8YFLogxK
U2 - 10.1097/FJC.0000000000000543
DO - 10.1097/FJC.0000000000000543
M3 - Article
C2 - 29286954
AN - SCOPUS:85042715841
VL - 71
SP - 38
EP - 45
JO - Journal of Cardiovascular Pharmacology
JF - Journal of Cardiovascular Pharmacology
SN - 0160-2446
IS - 1
ER -