Beta-Blockers May Raise Mortality in People With Diabetes 07105

Beta-Blockers May Raise Mortality in People With Diabetes

Use of beta-blockers may be associated with an increased mortality risk in patients with diabetes, particularly among those who have coronary heart disease (CHD), new research suggests.
The findings, from prospective cohort data from the US National Health and Nutrition Examination Survey 1999–2010, were published in the April issue of Mayo Clinic Proceedings by Tetsuro Tsujimoto, MD, PhD, of the Department of Diabetes, Endocrinology, and Metabolism, Center Hospital, Tokyo, Japan, and colleagues.
Among nearly 3000 participants with diabetes, all-cause mortality over 5 to 6 years was significantly higher in those taking beta-blockers than those who were not, with an even more pronounced effect among those with CHD.
In contrast, among nearly 15,000 participants without diabetes who had CHD, all-cause mortality was significantly reduced among those who took beta-blockers versus those who didn’t.  
Beta-adrenergic receptor blockers have been shown to improve survival in patients following myocardial infarction (MI), and in those with congestive heart failure (CHF) because of left ventricular systolic dysfunction.
But beyond that, Tsujimoto and colleagues note, “Beta-blockers have never been found to improve survival in all other patients with stable CHD in the absence of [MI] or CHF without systolic dysfunction. Moreover, the efficacy of beta-blockers in diabetic patients with CHD/CHF remains unknown.”
Tsujimoto and colleagues conclude, “Use of beta-blockers may be associated with an increased risk of mortality for patients with diabetes and among the subset who have CHD. Further studies are needed to assess whether beta-blockers are effective in reducing mortality and coronary events in diabetic patients receiving optimal medical treatment.”
Mayo Clin Proc. 2018;93:409-418. Abstract, Editorial

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