β-Blockers in Heart Failure: Breaking Tradition to Avoid Diabetes?

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Presentation transcript:

β-Blockers in Heart Failure: Breaking Tradition to Avoid Diabetes? Ragavendra R. Baliga, MD, MBA Heart Failure Clinics Volume 8, Issue 4, Pages xiii-xvi (October 2012) DOI: 10.1016/j.hfc.2012.07.002 Copyright © 2012 Terms and Conditions

Fig. 1 ASCOT-BPLA and risk of new onset diabetes with β-blockers. HR, hazard ratio; CI, confidence interval. [Adapted from Dahlof B, Sever PS, Poulter NR, et al. Prevention of cardiovascular events with an antihypertensive regimen of amlodipine adding perindopril as required versus atenolol adding bendroflumethiazide as required, in the Anglo-Scandinavian Cardiac Outcomes Trial-Blood Pressure Lowering Arm (ASCOT-BPLA): a multicentre randomised controlled trial. Lancet 2005;366(9489):895–906 with permission.] Heart Failure Clinics 2012 8, xiii-xviDOI: (10.1016/j.hfc.2012.07.002) Copyright © 2012 Terms and Conditions

Fig. 2 Relative risk of new onset diabetes by drug class. [Data from Elliott WJ, Meyer PM. Incident diabetes in clinical trials of antihypertensive drugs: a network meta-analysis. Lancet 2007;369(9557):201–7.] Heart Failure Clinics 2012 8, xiii-xviDOI: (10.1016/j.hfc.2012.07.002) Copyright © 2012 Terms and Conditions

Fig. 3 (A) Effect of Carvedilol (vasodilating β-blocker) on cardiac output and total peripheral resistance. (B) Effect of Metoprolol (traditional β-blocker) on cardiac output and total peripheral resistance. [From Weber K, Bohmeke T, van der Does R, et al. Comparison of the hemodynamic effects of metoprolol and carvedilol in hypertensive patients. Cardiovasc Drugs Ther 1996;10(2):113–7; with kind permission from Springer Science+Business Media B.V.] Heart Failure Clinics 2012 8, xiii-xviDOI: (10.1016/j.hfc.2012.07.002) Copyright © 2012 Terms and Conditions

Ragavendra R. Baliga, MD, MBA, Consulting Editor Heart Failure Clinics 2012 8, xiii-xviDOI: (10.1016/j.hfc.2012.07.002) Copyright © 2012 Terms and Conditions

James B. Young, MD, Consulting Editor Heart Failure Clinics 2012 8, xiii-xviDOI: (10.1016/j.hfc.2012.07.002) Copyright © 2012 Terms and Conditions