Selective beta-1 blockers deteriorate glucose metabolism. A meta-analysis

OBJECTIVE: To provide an up-to-date synthesis of available data, and to quantify the effect of highly selective beta-1 blockers on glucose metabolism in patients with essential hypertension and type diabetes mellitus (T2DM) by using pooled analysis techniques.

METHODS: Cochrane Library, PubMed, MEDLINE, and EMBASE databases were searched from inception to July 2013 in the Third Affiliated Hospital of Nanchang University, Nanchang, China. We collected randomized controlled trails reporting on the effect of highly selective beta-1 blockers on glucose metabolism in patients with hypertension and type 2 diabetes. Data was screened, evaluated, and extracted by 2 independent researchers according to the inclusion and exclusion criteria. Meta-analysis was conducted using RevMan5.0 software.

RESULTS: Seven trials were enrolled in the meta-analysis including a total of 1354 patients. Meta-analysis results revealed that when compared with the control group, selective beta-1 blockers were associated with a higher fasting blood glucose (weighed mean difference: 0.21, 95% confidence interval [CI]: 0.16-0.27; p<0.00001). But results revealed no significant difference in glycosylated hemoglobin (weighed mean difference: 0.13, 95% CI: -0.11 to 0.37; p=0.28), fasting insulin (weighed mean difference: -1.13, 95% CI: -4.27 to 2.01; p=0.48), and gain in body weight (weighed mean difference: 1, 95% CI: -1.08 to 3.08; p=0.35).

CONCLUSION: Selective beta-1 blockers were associated with elevated fasting blood glucose. Thus, it should not be used for patients with essential hypertension and diabetes.