Systemic hypertension-reviewA Meta-Analysis of 94,492 Patients With Hypertension Treated With Beta Blockers to Determine the Risk of New-Onset Diabetes Mellitus
Section snippets
Study selection
We conducted a search of studies on Medline, PubMed, and EMBASE using the terms: “β adrenergic blockers,” “adrenergic β antagonist,” “β blockers,” and “hypertension.” We limited our search to studies in human subjects published in English in peer-reviewed journals from 1966 to March 2007. We included only randomized controlled studies with randomized comparisons of regimens based on β blockers with those using other agents, with follow-up of ≥1 year, and evaluating the occurrence of new-onset
Study selection
Of the 805 randomized controlled trials of β blockers in patients with hypertension, 12 studies evaluating 94,492 patients fulfilled the inclusion criteria (Figure 1,Table 1, Table 2, Table 3). We excluded the results of the Metoprolol Atherosclerosis in Hypertension (MAPHY) trial19 because this was a subgroup analysis from the Heart Attack Primary Prevention in Hypertension (HAPPHY) trial.20 Similarly, we excluded the results of the Systolic Hypertension in the Elderly (SHEP) study,21 the
Discussion
The results of the present meta-analysis show that β-blocker therapy for hypertension is associated with increased risk for new-onset DM compared with nondiuretic antihypertensive drugs and also compared with placebo. This excess risk was greater in the cohort aged ≥60 years, in the cohort with higher baseline fasting glucose levels and higher baseline BMIs, and when the systolic blood pressure difference between the 2 treatment groups at study end was greater. The results of this analysis let
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