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Beta-Blockers enhance mortality risk in Diabetics with CHD : Study

Beta-Blockers enhance mortality risk in Diabetics with CHD : Study

Beta-adrenergic receptor blockers are used to improve survival in patients following myocardial infarction (MI), and in those with congestive heart failure (CHF) because of left ventricular systolic dysfunction. Dr.Tsujimoto, at the Department of Diabetes, Endocrinology, and Metabolism, Center Hospital, Tokyo, Japan, and colleagues conducted a prospective cohort study to assess the relationship between use of β-blockers and all-cause mortality in patients with and without diabetes.The researchers found that Use of beta-blockers may be associated with an increased mortality risk in patients with diabetes, particularly among those who have coronary heart disease (CHD). The findings of the new research were published in the April issue of Mayo Clinic Proceedings. 

The researchers conducted a prospective cohort study by using US National Health and Nutrition Examination Survey 1999-2010.  The study participants were followed-up from the survey participation date until December 31, 2011. A Cox proportional hazards model for all-cause mortality analysis was used.The multivariate-adjusted hazard ratios (HRs) of the participants taking β-blockers were compared with those of the participants not taking β-blockers.

The Investigators found that among nearly 3000 participants with diabetes, all-cause mortality over 5 to 6 years was significantly higher in those taking beta-blockers than those who were not, with an even more pronounced effect among those with CHD. However, among nearly 15,000 participants without diabetes who had CHD, all-cause mortality was significantly reduced among those who took beta-blockers versus those who didn’t.

 The authors concluded that use of β-blockers may be associated with an increased risk of mortality for patients with diabetes and among the subset who have CHD.Tsujimoto and colleagues note, “Beta-blockers have never been found to improve survival in all other patients with stable CHD in the absence of [MI] or CHF without systolic dysfunction. Moreover, the efficacy of beta-blockers in diabetic patients with CHD/CHF remains unknown.Further studies are needed to assess whether beta-blockers are effective in reducing mortality and coronary events in diabetic patients receiving optimal medical treatment.
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Source: With inputs mayo clinic

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