Publication:

Carvedilol versus beta-1 blockers as anti-hypertensive drugs in type-2 diabetes mellitus and pre-diabetic patients with features of metabolic syndrome: a meta-analysis

Background 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.