Document Detail


Effects of carvedilol versus metoprolol on endothelial function and oxidative stress in patients with type 2 diabetes mellitus.
MedLine Citation:
PMID:  17586413     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Data suggest that carvedilol possesses antioxidant properties that might provide vascular protection. We sought to compare the effects of carvedilol and metoprolol tartrate on endothelial function and oxidative stress in a head-to-head trial.
METHODS: Thirty-four patients with type 2 diabetes mellitus (T2DM) and hypertension were randomized to receive either carvedilol (n = 16) or metoprolol (n = 18) in addition to their current antihypertensive medications for 5 months. The following variables were measured pre- and posttreatment: blood pressure, fasting glucose and insulin, insulin resistance by homeostasis-model assessment, hemoglobin A1c, lipids, C-reactive protein (CRP), 8-isoprostane, asymmetric dimethylarginine, oxidized LDL cholesterol, ultrasound assessment of brachial-artery flow-mediated dilation (FMD), nitroglycerin-induced endothelium-independent dilation (EID), brachial and carotid artery distension, distensibility and compliance, and carotid artery intima-media thickness (cIMT).
RESULTS: Both carvedilol and metoprolol treatment resulted in significant and similar decreases in systolic (P < .05) and diastolic (P < .0001) blood pressure. Compared with metoprolol, carvedilol significantly improved FMD (P < .001). No differences between groups were noted for any of the glycemic or lipid variables except for HDL cholesterol, which significantly decreased (P < .05) in the metoprolol group compared with the carvedilol group. No differences were observed between groups for CRP, the markers of oxidative stress, EID, arterial stiffness, or cIMT.
CONCLUSIONS: Compared with metoprolol, carvedilol significantly improves endothelial function in patients with T2DM. Changes in glycemic control and oxidative stress do not seem to explain the observed improvements in FMD, which suggests that other mechanisms may be involved.
Authors:
Alan J Bank; Aaron S Kelly; Andrea M Thelen; Daniel R Kaiser; J Michael Gonzalez-Campoy
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Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  American journal of hypertension     Volume:  20     ISSN:  0895-7061     ISO Abbreviation:  Am. J. Hypertens.     Publication Date:  2007 Jul 
Date Detail:
Created Date:  2007-06-25     Completed Date:  2007-11-01     Revised Date:  2013-05-28    
Medline Journal Info:
Nlm Unique ID:  8803676     Medline TA:  Am J Hypertens     Country:  United States    
Other Details:
Languages:  eng     Pagination:  777-83     Citation Subset:  IM    
Affiliation:
Department of Research, St. Paul Heart Clinic, St. Paul, Minnesota, USA. abank@stphc.com
Data Bank Information
Bank Name/Acc. No.:
ClinicalTrials.gov/NCT00123604
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MeSH Terms
Descriptor/Qualifier:
Aged
Antihypertensive Agents / therapeutic use*
Carbazoles / therapeutic use*
Diabetes Mellitus, Type 2 / complications,  physiopathology*
Double-Blind Method
Endothelium, Vascular / drug effects*,  physiology
Female
Humans
Hypertension / complications,  drug therapy*
Male
Metoprolol / therapeutic use*
Middle Aged
Oxidative Stress / drug effects*
Propanolamines / therapeutic use*
Chemical
Reg. No./Substance:
0/Antihypertensive Agents; 0/Carbazoles; 0/Propanolamines; 0K47UL67F2/carvedilol; 37350-58-6/Metoprolol

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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