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October 31, 2012
COLUMBUS, Ohio –Beta-blockers traditionally prescribed in the past have successfully been used to treat a variety of cardiovascular conditions, but increasingly, studies show some may contribute to the diabetes pandemic.
“I am switching many of my patients to a ‘newer’ beta-blocker which is less likely to cause diabetes while proving just as effective in treating heart failure and other conditions,” said Dr. Ragavendra Baliga, a cardiologist at The Ohio State University Wexner Medical Center.
Some cardiologists, including Baliga, are prescribing alternative types of the medication. Baliga recently published an editorial on the topic in Heart Failure Clinics of North America, titled, “Beta-Blockers in Heart Failure: Breaking Tradition to Avoid Diabetes?”
“The ‘newer’ beta-blockers are less likely to cause diabetes while proving just as effective in treating high blood pressure, heart failure and other conditions,” said Baliga.
According to Baliga, beta-blockers save lives in heart attacks, heart failure, high blood pressure and cardiac arrhythmia. They are used frequently for common conditions like migraines, glaucoma, tremors, hyper-active thyroids and more. The benefits of beta-blockers include reversal of cardiac remodeling, a decrease heart rate and blood pressure, prevention of sudden death and improved endothelial function with plaque stabilization.
However, when used for long periods of time, Baliga cautions that some beta-blockers like atenolol have potentially detrimental metabolic side-effects including weight increase, adverse effects on lipid profiles and an impact on insulin sensitivity.
“Beta-blockers can be a double-edge sword,” said Baliga. “As physicians, we need them to save lives, but we also need to keep our patients safe from harmful side-effects.”
Up until 2007, atenolol was among the few generically available for treatment of common conditions like high blood pressure, and many people used it, although there was an associated higher risk of subsequent diabetes. Baliga says if there are no other limitations, he typically considers substituting this medication for carvedilol, which many patients may not realize is now generic.
Recently, in small studies, carvedilol improved skeletal muscle blood supply, allowing insulin to act more efficiently, helping to prevent the onset of diabetes.
In his editorial, Baliga writes, perhaps it is time to break tradition to avoid the risk of diabetes associated with long-term utilization of some beta-blockers. To patients, he says we need to be vigilant about medications we are taking for our conditions and the risks associated with them.
“You should never switch medications without consulting your physician,” said Baliga.
Baliga has no contractual agreement with Carvedilol USP, maker of carvedilol, or Astra-Zeneca maker of atenolol.