Abstract:
It is unclear and contradictory on to whether carvedilol is
preferable over beta-1 blockers as add-on drug in hypertensive pre-diabetic and
diabetic patients with metabolic syndrome. The objective of this study was to
compare the effects of carvedilol versus beta-1 blockers on hemodynamic
parameters, indicators of insulin resistance and plasma lipid levels in
hypertensive diabetic and pre-diabetic patients with features of metabolic
syndrome.
Methods: Electronic database search in Pubmed, Cochrane library and
EMBASE was conducted. Randomized or cross-over studies comparing effects
of carvedilol against beta-1 blockers were included under analysis. Statistical
analysis by inverse variance method and both random and fixed effect models
was conducted by using RevMan 5.3.
Results: Six studies were eligible and included in the analysis. There was minor
but significant decrease in SBP (mean difference, MD = -1.38mm Hg, 95% CI =
-2.09,-0.66) and HbA1C% (MD = -0.21%, 95% CI -0.41 to -0.02) by carvedilol
in patients with type-2 DM.
Conclusions: There is moderate quality of evidence to suggest that carvedilol
has mild but significant SBP and HbA1C% lowering effect compared to beta-1
blockers in hypertensive patients with type-2 DM.
