Beta-adrenoceptor antagonists and ACE-inhibitors. Carvedilol compared with metoprolol as combination partner in cases of diabetes and hypertension

摘要

Nearly all type 2 diabetic patients are suffering from arterial hypertension. The latter usually becomes manifest earlier than the diabetic metabolic disturbances. Adequate treatment often requires a combination of angiotensin converting enzyme(ACE)-inhibitors and beta-adrenoceptor antagonists. Metoprolol is still the most frequently used beta-adrenoceptor antagonist in this setting. Some clinical trials have shown carvedilol to be superior in improving the metabolic situation and prevention of secondary disorders caused by diabetes. Therefore carvedilol may be the beta-adrenoceptor antagonist of choice for treatment of patients at high cardiovascular risk and especially for diabetes type 2. As comparisons to metoprolol succinate as well as to optimally dosed metoprolol tartrate are missing, a definite superiority of carvedilol cannot be assumed.