Effects of β-blockers on glucose and lipid metabolism

Current Medical Research and Opinion

Volumn 26, Issue 3, 2010, Pages 615-629

  Fonseca, Vivian A ^a  

^a TULANE UNIVERSITY SCHOOL OF MEDICINE   (United States)

Author keywords

Adrenergic; Beta; Blockers; Diabetes mellitus; Dyslipidemias; Hypertension

Indexed keywords

ANGIOTENSIN RECEPTOR ANTAGONIST; ANTIDIABETIC AGENT; ANTIHYPERTENSIVE AGENT; ANTILIPEMIC AGENT; ATENOLOL; BETA ADRENERGIC RECEPTOR BLOCKING AGENT; BISOPROLOL; CALCIUM ANTAGONIST; CARVEDILOL; DIPEPTIDYL CARBOXYPEPTIDASE INHIBITOR; GLICLAZIDE; GLUCOSE; HIGH DENSITY LIPOPROTEIN CHOLESTEROL; INDAPAMIDE PLUS PERINDOPRIL; LABETALOL; LIPID; LOSARTAN; LOW DENSITY LIPOPROTEIN CHOLESTEROL; METOPROLOL; METOPROLOL TARTRATE; NEBIVOLOL; OXIDIZED LOW DENSITY LIPOPROTEIN; PINDOLOL; PROPRANOLOL; THIAZIDE DIURETIC AGENT; TRANDOLAPRIL; TRIACYLGLYCEROL; UNINDEXED DRUG; VERAPAMIL; VERY LOW DENSITY LIPOPROTEIN CHOLESTEROL;

ADRENERGIC RECEPTOR BLOCKING; ADRENERGIC SYSTEM; ANTIHYPERTENSIVE THERAPY; ATHEROSCLEROSIS; CARDIOVASCULAR DISEASE; CARDIOVASCULAR RISK; CLINICAL PRACTICE; COMORBIDITY; CORONARY ARTERY DISEASE; CORONARY RISK; DEPRESSION; DIABETES MELLITUS; DRUG DOSE COMPARISON; DRUG DOSE INCREASE; DRUG EFFECT; DRUG MECHANISM; DRUG TOLERABILITY; DRUG WITHDRAWAL; DYSLIPIDEMIA; ENVIRONMENTAL FACTOR; ESSENTIAL HYPERTENSION; FATIGUE; GLUCOSE BLOOD LEVEL; GLUCOSE METABOLISM; HEALTH SURVEY; HEART LEFT VENTRICLE FUNCTION; HEART OUTPUT; HEART PROTECTION; HIGH RISK PATIENT; HUMAN; HYPERINSULINEMIA; HYPERTENSION; HYPOGLYCEMIA; IMPAIRED GLUCOSE TOLERANCE; INSULIN RESISTANCE; INSULIN SENSITIVITY; LIPID METABOLISM; PATHOPHYSIOLOGY; PATIENT COMPLIANCE; PRACTICE GUIDELINE; RENIN ANGIOTENSIN ALDOSTERONE SYSTEM; REVIEW; RISK REDUCTION; SEXUAL DYSFUNCTION; SIDE EFFECT; STROKE; TREATMENT OUTCOME; VASCULAR RESISTANCE; VASODILATATION; WEIGHT GAIN;

ADRENERGIC BETA-ANTAGONISTS; BLOOD PRESSURE; CARDIAC OUTPUT; CARDIOVASCULAR DISEASES; GLUCOSE; HUMANS; LIPID METABOLISM; RANDOMIZED CONTROLLED TRIALS AS TOPIC; SYMPATHETIC NERVOUS SYSTEM; VASCULAR RESISTANCE;

EID: 76949103329     PISSN: 03007995     EISSN: 14734877     Source Type: Journal    
DOI: 10.1185/03007990903533681     Document Type: Review

References (128)

1. Rosamond W, Flegal K, Friday G, et al. Heart disease and stroke statistics-2007 update: a report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Circulation 2007;115: e69-171
2. Vasan RS, Beiser A, Seshadri S, et al. Residual lifetime risk for developing hypertension in middle-aged women and men: the Framingham Heart Study. JAMA 2002;287:1003-1010 (Pubitemid 34252058)
3. Chobanian AV, Bakris GL, Black HR, et al. Seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Hypertension 2003;42:1206-1252
4. Lewington S, Clarke R, Qizilbash N, et al. Age-specific relevance of usual blood pressure to vascular mortality: a meta-analysis of individual data for one million adults in 61 prospective studies. Lancet 2002;360:1903-1913
5. Rosamond W, Flegal K, Furie K, et al. Heart disease and stroke statistics-2008 update: a report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Circulation 2008;117:e25-146
6. Johnson ML, Pietz K, Battleman DS, et al. Prevalence of comorbid hypertension and dyslipidemia and associated cardiovascular disease. Am J Manag Care 2004;10:926-932
7. Executive Summary of the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). JAMA 2001;285:2486-2497.
8. Suskin N, McKelvie RS, Burns RJ, et al. Glucose and insulin abnormalities relate to functional capacity in patients with congestive heart failure. Eur Heart J 2000;21:1368-1375
9. Frishman WH. A historical perspective on the development of beta-adrenergic blockers. J Clin Hypertens 2007;9(4 Suppl. 3):19-27
10. Egan BM, Basile J, Chilton RJ, et al. Cardioprotection: the role of beta-blocker therapy. J Clin Hypertens (Greenwich) 2005;7:409-416
11. Messerli FH, Grossman E. Beta-blockers in hypertension: is carvedilol different? Am J Cardiol 2004;93:7B-12B
12. Sarafidis PA, Bakris GL. Antihypertensive treatment with beta-blockers and the spectrum of glycaemic control. QJM 2006;99:431-436
13. Pedersen ME, Cockcroft JR. The vasodilatory beta-blockers. Curr Hypertens Rep 2007;9:269-277
14. Garcia-Puig J, Ruilope LM, Luque M, et al. Glucose metabolism in patients with essential hypertension. Am J Med 2006;119:318-326
15. Izzo Jr JL, Sica DA, Black HR. Hypertension Primer: The Essentials of High Blood Pressure, 4th Edn. Philadelphia: Lippincott Williams & Wilkins, 2008
16. Halperin RO, Sesso HD, Ma J, et al. Dyslipidemia and the risk of incident hypertension in men. Hypertension 2006;47:45-50
17. Stamler J, Vaccaro O, Neaton JD, et al. Diabetes, other risk factors, and 12-yr cardiovascular mortality for men screened in the Multiple Risk Factor Intervention Trial. Diabetes Care 1993;16:434-444
18. Govindarajan G, Whaley-Connell A, Mugo M, et al. The cardiometabolic syndrome as a cardiovascular risk factor. Am J Med Sci 2005;330:311-318
19. Pauletto P, Scannapieco G, Pessina AC. Sympathetic drive and vascular damage in hypertension and atherosclerosis. Hypertension 1991;17 (4 Suppl.):11175-81
20. Kreisberg RA. Diabetic dyslipidemia. Am J Cardiol 1998;82(12A):67U-73U; discussion 85U-6U
21. Mertens A, Holvoet P. Oxidized LDL and HDL: antagonists in atherothrombo-sis. Faseb J 2001;15:2073-2084
22. Sun N, Wood NB, Hughes AD, et al. Effects of transmural pressure and wall shear stress on LDL accumulation in the arterial wall: a numerical study using a multilayered model. Am J Physiol Heart Circ Physiol 2007;292: H3148-57
23. Finet G, Ohayon J, Rioufol G, et al. Morphological and biomechanical aspects of vulnerable coronary plaque. Arch Mal Coeur Vaiss 2007;100:547-553
24. Munger MA, Hawkins DW. Atherothrombosis: epidemiology, pathophysiology, and prevention. J Am Pharm Assoc (2003) 2004;44(2 Suppl. 1):S5-12; quiz S12-13
25. Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). UK Prospective Diabetes Study (UKPDS) Group. Lancet 1998;352:837-853
26. MRC/BHF Heart Protection Study of cholesterol lowering with simvastatin in 20,536 high-risk individuals: a randomised placebo-controlled trial. Lancet 2002;360:7-22
27. Sever PS, Poulter NR, Dahlof B, et al. Reduction in cardiovascular events with atorvastatin in 2,532 patients with type 2 diabetes: Anglo-Scandinavian Cardiac Outcomes Trial-Lipid-Lowering Arm (ASCOT-LLA). Diabetes Care 2005;28:1151-1157 (Pubitemid 40616627)
28. Patel A, MacMahon S, Chalmers J, et al. Intensive blood glucose control and vascular outcomes in patients with type 2 diabetes. The ADVANCE Collaborative Group. N Engl J Med 2008;358:2560-2572
29. Duckworth W, Abraira C, Moritz T, et al. Glucose control and vascular complications in veterans with type 2 diabetes. N Engl J Med 2009;360: 129-139
30. Gerstein HC, Miller ME, Byington RP, et al. Effects of intensive glucose lowering in type 2 diabetes. N Engl J Med 2008;358:2545-2559
31. American Diabetes Association. Standards of Medical Care in Diabetes-2007. Diabetes Care 2007;30(Suppl. 1):S4-41
32. Koro CE, Bowlin SJ, Bourgeois N, et al. Glycemic control from 1988 to 2000 among U.S. adults diagnosed with type 2 diabetes: a preliminary report. Diabetes Care 2004;27:17-20
33. Ghandehari H, Kamal-Bahl S, Wong ND. Prevalence and extent of dyslipide-mia and recommended lipid levels in US adults with and without cardiovascular comorbidities: the National Health and Nutrition Examination Survey 2003-2004. Am Heart J 2008;156:112-119
34. Mancia G, Grassi G, Giannattasio C, et al. Sympathetic activation in the pathogenesis of hypertension and progression of organ damage. Hypertension 1999;34(4 Pt 2):724-728
35. Packer M. Beta-adrenergic blockade in chronic heart failure: principles, progress, and practice. Prog Cardiovasc Dis 1998;41(1 Suppl. 1):39-52
36. Lopez-Sendon J, Swedberg K, McMurray J, et al. Expert consensus document on beta-adrenergic receptor blockers. Eur Heart J 2004;25:1341-1362
37. Bell DS. Optimizing treatment of diabetes and cardiovascular disease with combined alpha,beta-blockade. Curr Med Res Opin 2005;21:1191-1200
38. Bangalore S, Messerli FH, Kostis JB, et al. Cardiovascular protection using beta-blockers: a critical review of the evidence. J Am Coll Cardiol 2007; 50:563-572
39. Ko DT, Hebert PR, Coffey CS, et al. Beta-blocker therapy and symptoms of depression, fatigue, and sexual dysfunction. JAMA 2002;288:351-357
40. Jacob S, Rett K, Wicklmayr M, et al. Differential effect of chronic treatment with two beta-blocking agents on insulin sensitivity: the carvedilol-metoprolol study. J Hypertens 1996;14:489-494
41. Lithell HO. Effect of antihypertensive drugs on insulin, glucose, and lipid metabolism. Diabetes Care 1991;14:203-209
42. Aberg H, Morlin C, Lithell H. Different long-term metabolic effects of enalapril and atenolol in patients with mild hypertension. EGTA Group. J Hum Hypertens 1995;9:149-153
43. Helgeland A, Strommen R, Hagelund CH, et al. Enalapril, atenolol, and hydro-chlorothiazide in mild to moderate hypertension. A comparative multicentre study in general practice in Norway. Lancet 1986;1:872-875
44. Jacob S, Klimm HJ, Rett K, et al. Effects of moxonidine vs. metoprolol on blood pressure and metabolic control in hypertensive subjects with type 2 diabetes. Exp Clin Endocrinol Diabetes 2004;112:315-322
45. Berglund G, Andersson O, Widgren B. Low-dose antihypertensive treatment with a thiazide diuretic is not diabetogenic. A 10-year controlled trial with bendroflumethiazide. Acta Med Scand 1986;220:419-424 (Pubitemid 17232389)
46. Propranolol or hydrochlorothiazide alone for the initial treatment of hypertension. IV. Effect on plasma glucose and glucose tolerance. Veterans Administration Cooperative Study Group on Antihypertensive Agents. Hypertension 1985;7(6 Pt 1):1008-1016
47. Sourgens H, Schmidt J, Derendorf H. Comparison of talinolol and atenolol effects on blood pressure in relation to lipid and glucose metabolic parameters. Results from the TALIP study. Int J Clin Pharmacol Ther 2003; 41:22-29
48. Chrysant SG, Chappel C, Farnham DJ, et al. Antihypertensive and metabolic effects of single and combined atenolol regimens. J Clin Pharmacol 1992;32:61-65
49. Ruilope LM. Comparison of a new vasodilating beta-blocker, carvedilol, with atenolol in the treatment of mild to moderate essential hypertension. Am J Hypertens 1994;7:129-136
50. Bagatin J, Sardelic S, Pivac N, et al. Comparison of chlorthalidone, propra-nolol and bopindolol in six-month treatment of arterial hypertension. Int J Clin Pharmacol Res 1998;18:73-78
51. Perez-Stable EJ, Coates TJ, Baron RB, et al. Comparison of a lifestyle modification program with propranolol use in the management of diastolic hypertension. J Gen Intern Med 1995;10:419-428
52. Haenni A, Lithell H. Treatment with a beta-blocker with beta 2-agonism improves glucose and lipid metabolism in essential hypertension. Metabolism 1994;43:455-461
53. Khaw K-T, Wareham N, Bingham S, et al. Association of hemoglobin A1c with cardiovascular disease and mortality in adults: the European Prospective Investigation into Cancer in Norfolk. Ann Intern Med 2004;141:413-420
54. Myint PK, Sinha S, Wareham NJ, et al. Glycated hemoglobin and risk of stroke in people without known diabetes in the European Prospective Investigation into Cancer (EPIC)-Norfolk prospective population study: a threshold relationship? Stroke 2007;38:271-275
55. Gress TW, Nieto FJ, Shahar E, et al. Hypertension and antihypertensive therapy as risk factors for type 2 diabetes mellitus. Atherosclerosis Risk in Communities Study. N Engl J Med 2000;342:905-912
56. Dahlof B, Devereux RB, Kjeldsen SE, et al. Cardiovascular morbidity and mortality in the Losartan Intervention For Endpoint reduction in hypertension study (LIFE): a randomised trial against atenolol. Lancet 2002;359: 995-1003 (Pubitemid 34286536)
57. Pepine CJ, Handberg EM, Cooper-DeHoff RM, et al. A calcium antagonist vs a non-calcium antagonist hypertension treatment strategy for patients with coronary artery disease. The International Verapamil-Trandolapril Study (INVEST): a randomized controlled trial. JAMA 2003;290:2805-2816
58. Gupta AK, Dahlof B, Dobson J, et al. Determinants of new-onset diabetes among 19,257 hypertensive patients randomized in the Anglo-Scandinavian Cardiac Outcomes Trial-Blood Pressure Lowering Arm and the relative influence of antihypertensive medication. Diabetes Care 2008;31:982-988
59. Owada A, Suda S, Hata T, et al. The effects of bisoprolol, a selective beta1-blocker, on glucose metabolism by long-term administration in essential hypertension. Clin Exp Hypertens 2001;23:305-316
60. Abdelmawla AH, Langley RW, Szabadi E, et al. Bisoprolol attenuates nora-drenaline-and phenylephrine-evoked venoconstriction in man in vivo. Br J Clin Pharmacol 1997;44:61-68
61. 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; 366:895-906
62. Joglekar SJ, Jaguste V, Nanivadekar AS. Prazosin GITS vs atenolol in patients with hypertension and normal lipid profile: a randomized, controlled multi-center study. Hyderabad Hypertension Study Group. J Assoc Physicians India 1998;Suppl. 1:41-51
63. Lakshman MR, Reda DJ, Materson BJ, et al. Diuretics and beta-blockers do not have adverse effects at 1 year on plasma lipid and lipoprotein profiles in men with hypertension. Department of Veterans Affairs Cooperative Study Group on Antihypertensive Agents. Arch Intern Med 1999;159:551-558
64. Thulin T, Lehtonen A, Dahlof C, et al. Long-term effects of diltiazem and atenolol on blood glucose, serum lipids, and serum urate in hypertensive patients. Swedish-Finnish Study Group. Int J Clin Pharmacol Ther 1999; 37:28-33
65. Fogari R, Zoppi A, Malamani GD, et al. Effects of different antihypertensive drugs on plasma fibrinogen in hypertensive patients. Br J Clin Pharmacol 1995;39:471-476
66. van der Does R, Widmann L, Uberbacher HJ, et al. Efficacy and safety of carvedilol in comparison with atenolol in hypertensive patients pretreated with hydrochlorothiazide. Eur J Clin Pharmacol 1990;38(Suppl. 2):S147-52
67. Daae LN, Westlie L. A 5-year comparison of doxazosin and atenolol in patients with mild-to-moderate hypertension: effects on blood pressure, serum lipids, and coronary heart disease risk. Blood Press 1998;7:39-45
68. Schmitz G, Stumpe KO, Herrmann W, et al. Effects of bunazosin and atenolol on serum lipids and apolipoproteins in a randomised trial. Blood Press 1996;5:354-359
69. Rabkin SW, Huff MW, Newman C, et al. Lipids and lipoproteins during anti-hypertensive drug therapy. Comparison of doxazosin and atenolol in a randomized, double-blind trial: the Alpha Beta Canada Study. Hypertension 1994;24:241-248
70. Dujovne CA, Eff J, Ferraro L, et al. Comparative effects of atenolol versus celiprolol on serum lipids and blood pressure in hyperlipidemic and hypertensive subjects. Am J Cardiol 1993;72:1131-1136
71. Otterstad JE, Froeland G, Soeyland AK, et al. Lipid profile in 100 men with moderate hypertension treated for 1 year with atenolol or hydrochlorothiazide plus amiloride: a double-blind, randomized study. Scand J Clin Lab Invest 1992;52:83-93
72. Talseth T, Westlie L, Daae L. Doxazosin and atenolol as monotherapy in mild and moderate hypertension: a randomized, parallel study with a three-year follow-up. Am Heart J 1991;121(1 Pt 2):280-285
73. Talseth T, Westlie L, Daae L. A long-term study of atenolol and doxazosin in mild and moderate hypertension. J Hum Hypertens 1990;4(Suppl. 3):39-44
74. Frick MH, Halttunen P, Himanen P, et al. A long-term double-blind comparison of doxazosin and atenolol in patients with mild to moderate essential hypertension. Br J Clin Pharmacol 1986;21(Suppl. 1):55S-62S
75. Johnston GD, Vyssoulis G, Feely J, et al. Effect of celiprolol and metoprolol on lipids, fibrinogen and airways function in hyperlipidaemic hypertensives: a randomised double-blind long-term parallel group trial. J Hum Hypertens 1995;9:123-129
76. Zanchetti A. Addition of urapidil or metoprolol to the treatment of hypertensive non-responders to nifedipine monotherapy: efficacy and metabolic effects. Italian Urapidil Study Group. Blood Press Suppl 1995;3:38-46
77. Foss OP, Jensen EK. The effect of captopril and metoprolol as monotherapy or combined with bendroflumethiazide on blood lipids. J Intern Med 1990; 227:119-123
78. Hedner T, Thulin T, Gustafsson S, et al. A comparison of diltiazem and metoprolol in hypertension. Swedish Diltiazem-Metoprolol Multicentre Study Group. Eur J Clin Pharmacol 1990;39:427-433
79. Materson BJ, Vlachakis ND, Glasser SP, et al. Influence of beta 2 agonism and beta 1 and beta 2 antagonism on adverse effects and plasma lipoproteins: results of a multicenter comparison of dilevalol and metoprolol. Am J Cardiol 1989;63:58I-63I
80. Tuomilehto J, Nissinen A, Honkavaara M. Clinical evaluation of the antihypertensive effect of metoprolol in combination with hydrochlorothiazide and hydralazine in an unselected hypertensive population. Acta Cardiol 1980; 35:289-301
81. Fogari R, Zoppi A, Pasotti C, et al. Plasma lipids during chronic antihypertensive therapy with different beta-blockers. J Cardiovasc Pharmacol 1989; 14(Suppl. 7):S28-32
82. Zusman R, Christensen D, Federman E, et al. Comparison of nifedipine and propranolol used in combination with diuretics for the treatment of hypertension. Am J Med 1987;82(3B):37-41
83. Saunders E, Curry C, Hinds J, et al. Labetalol compared with propranolol in the treatment of black hypertensive patients. J Clin Hypertens 1987; 3:294-302
84. Goto Y. Effects of alpha-and beta-blocker antihypertensive therapy on blood lipids: a multicenter trial. Am J Med 1984;76(2A):72-78
85. Helgeland A. Double-blind comparison of trimazosin and propranolol in essential hypertension. Am Heart J 1983;106(5 Pt 2):1253-1258
86. Tang WH. A critical review of anti-adrenergic therapy in patients with heart failure and diabetes mellitus. Vasc Health Risk Manag 2007;3:639-645
87. DeFronzo RA, Mandarino L, Ferrannini E. Metabolic and molecular pathogenesis of type 2 diabetes mellitus. In: DeFronzo RA, Ferrannini E, Keen H, Zimmet P (eds). International Textbook of Diabetes Mellitus, 3rd edn. Chichester, UK: John Wiley & Sons Ltd, 2004:359-373
88. Efficacy of atenolol and captopril in reducing risk of macrovascular and microvascular complications in type 2 diabetes: UKPDS 39. UK Prospective Diabetes Study Group. Br Med J 1998;317:713-720
89. Rossner S, Taylor CL, Byington RP, et al. Long term propranolol treatment and changes in body weight after myocardial infarction. BMJ 1990; 300:902-903
90. Afonso RA, Patarrao RS, Macedo MP, et al. Carvedilol's actions are largely mediated by endogenous nitric oxide. Rev Port Cardiol 2006;25:911-917
91. COREG CR® (carvedilol phosphate) Extended-release Capsules (prescribing information). Research Triangle Park, NC: Glaxo Smith Kline, Inc., 2008
92. COREG® (carvedilol) Tablets (prescribing information). Research Triangle Park, NC: Glaxo Smith Kline, Inc., 2008
93. Agabiti Rosei E, Rizzoni D. Metabolic profile of nebivolol, a beta-adrenocep-tor antagonist with unique characteristics. Drugs 2007;67:1097-1107
94. Bakris GL, Fonseca V, Katholi RE, et al. Metabolic effects of carvedilol vs metoprolol in patients with type 2 diabetes mellitus and hypertension: a randomized controlled trial. JAMA 2004;292:2227-2236
95. Hauf-Zachariou U, Widmann L, Zulsdorf B, et al. A double-blind comparison of the effects of carvedilol and captopril on serum lipid concentrations in patients with mild to moderate essential hypertension and dyslipidaemia. Eur J Clin Pharmacol 1993;45:95-100
96. Kusljugic Z, Divkovic K, Barakovic F, et al. Effects of nebivolol on artery hypertension-multicentre study Bosnia and Herzegovina. Bosn J Basic Med Sci 2005;5:42-51
97. Rizos E, Bairaktari E, Kostoula A, et al. The combination of nebivolol plus pravastatin is associated with a more beneficial metabolic profile compared to that of atenolol plus pravastatin in hypertensive patients with dyslipidemia: a pilot study. J Cardiovasc Pharmacol Ther. 2003;8:127-134
98. Schmidt AC, Graf C, Brixius K, et al. Blood pressure-lowering effect of nebivolol in hypertensive patients with type 2 diabetes mellitus: the YESTONO study. Clin Drug Investig 2007;27:841-849
99. Celik T, Iyisoy A, Kursaklioglu H, et al. Comparative effects of nebivolol and metoprolol on oxidative stress, insulin resistance, plasma adiponectin and soluble P-selectin levels in hypertensive patients. J Hypertens 2006; 24:591-596
100. BYSTOLIC® (nebivolol) Tablets (prescribing information). St. Louis, MO: Forest Pharmaceuticals, Inc., 2008
101. Louis WJ, McNeil JJ, Drummer OH. Pharmacology of combined alpha-beta-blockade. I. Drugs 1984(Suppl. 2):16-34
102. Ohman KP, Weiner L, von Schenck H, et al. Antihypertensive and metabolic effects of nifedipine and labetalol alone and in combination in primary hypertension. Eur J Clin Pharmacol 1985;29:149-154
103. Siwach SB, Dahiya SS, Seth S, et al. Effect of atenolol and labetalol on serum lipids. J Assoc Physicians India 1993;41:293-294
104. Frishman WH, Michelson EL, Johnson BF, et al. Multiclinic comparison of labetalol to metoprolol in treatment of mild to moderate systemic hypertension. Am J Med 1983;75(4A):54-67
105. Schamaun O, Westheim A, Qvigstad EK, et al. A comparative study on the effect of atenolol and labetalol on exercise capacity and lipid serum levels in essential hypertension. Nephron 1987;47(Suppl. 1):135-137
106. Farry JP, Fischl SJ, Tighe MJ, et al. Effects of prazosin and labetalol on blood pressure control and blood lipid levels in patients with mild-to-moderate essential hypertension. Am J Med 1989;86(1B):41-44
107. Lucas C, Jenkins P, Mendels J, et al. The effectiveness of labetalol compared to hydrochlorothiazide in hypertensive black patients. J Natl Med Assoc 1991;83:866-871
108. Kozlovski VI, Lomnicka M, Chlopicki S. Nebivovol and carvedilol induce NO-dependent coronary vasodilatation that is unlikely to be mediated by extracellular ATP in the isolated guinea pig heart. Pharmacol Rep 2006;58(Suppl.):103-110
109. Toda N. Vasodilating beta-adrenoceptor blockers as cardiovascular therapeutics. Pharmacol Ther 2003;100:215-234
110. Giugliano D, Marfella R, Acampora R, et al. Effects of perindopril and carvedilol on endothelium-dependent vascular functions in patients with diabetes and hypertension. Diabetes Care 1998;21:631-636
111. Gonzalez Maqueda I. Adrenoreceptors, endothelial function, and lipid profile: effects of atenolol, doxazosin, and carvedilol. Coron Artery Dis 1994; 5:909-918
112. Tzemos N, Lim PO, MacDonald TM. Nebivolol reverses endothelial dysfunction in essential hypertension: a randomized, double-blind, crossover study. Circulation 2001;104:511-514
113. Dandona P, Ghanim H, Brooks DP. Antioxidant activity of carvedilol in cardiovascular disease. J Hypertens 2007;25:731-741
114. Keith M, Geranmayegan A, Sole MJ, et al. Increased oxidative stress in patients with congestive heart failure. J Am Coll Cardiol 1998;31: 1352-1356
115. Giugliano D, Acampora R, Marfella R, et al. Metabolic and cardiovascular effects of carvedilol and atenolol in non-insulin-dependent diabetes mellitus and hypertension. A randomized, controlled trial. Ann Intern Med 1997; 126:955-959
116. Maggi E, Marchesi E, Covini D, et al. Protective effects of carvedilol, a vasodilating beta-adrenoceptor blocker, against in vivo low density lipopro-tein oxidation in essential hypertension. J Cardiovasc Pharmacol 1996;27: 532-538
117. Moreno AJ, Santos DJ, Palmeira CM. Ischemic heart disease: the role of mitochondria-carvedilol prevents lipid peroxidation of mitochondrial membranes. Rev Port Cardiol 1998;17(Suppl. 2):1163-77
118. Nakamura K, Kusano K, Nakamura Y, et al. Carvedilol decreases elevated oxidative stress in human failing myocardium. Circulation 2002;105(24): 2867-2871
119. Sesso HD, Buring JE, Christen WG, et al. Vitamins E and C in the prevention of cardiovascular disease in men: the Physicians' Health Study II randomized controlled trial. JAMA 2008;300:2123-2133
120. Fratta Pasini A, Garbin U, Nava MC, et al. Nebivolol decreases oxidative stress in essential hypertensive patients and increases nitric oxide by reducing its oxidative inactivation. J Hypertens 2005;23: 589-596
121. Flammer AJ, Hermann F, Wiesli P, et al. Effect of losartan, compared with atenolol, on endothelial function and oxidative stress in patients with type 2 diabetes and hypertension. J Hypertens 2007;25:785-791
122. de Ferranti SD, Rifai N. C-reactive protein: a nontraditional serum marker of cardiovascular risk. Cardiovasc Pathol 2007;16:14-21
123. King DE, Egan BM, Mainous 3rd AG, et al. The effect of extended-release metoprolol succinate on C-reactive protein levels in persons with hypertension. J Clin Hypertens (Greenwich) 2006;8:257-260
124. Messerli FH, Bell DSH, Fonseca V, et al. Body weight changes with beta-blocker use: results from GEMINI. Am J Med 2007;120:610-615
125. Peter P, Martin U, Sharma A, et al. Effect of treatment with nebivolol on parameters of oxidative stress in type 2 diabetics with mild to moderate hypertension. J Clin Pharm Ther 2006;31:153-159
126. Mancia G, De Backer G, Dominiczak A, et al. 2007 Guidelines for the management of arterial hypertension: The Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). Eur Heart J 2007;28:1462-1536
127. Torre JJ, Bloomgarden ZT, Dickey RA, et al. American Association of Clinical Endocrinologists Medical Guidelines for Clinical Practice for the diagnosis and treatment of hypertension. Endocr Pract 2006;12: 193-222
128. National Institute for Health and Clinical Excellence. Hypertension: management of hypertension in adults in primary care. NICE Clinical Guideline 34. June 2006. Available at: www.nice.org.uk/guidance/index.jsp?action download&o30114 [Last accessed 13 January 2009]