Abstract 15485: Selective β1-Blockers Are Not Associated With New-Onset Diabetes Mellitus in Hypertensive Patients
Background: Although ß-blockers are known to increase new-onset diabetes mellitus (DM), previous evidence have been controversial. It has been suggested that newer vasodilatory ß-blockers yield better glycemic control than older non-selective agents. The aim of this study was to evaluate the diabetogenicity of currently used newer ß-blockers based on ß1 receptor selectivity in a series of Asian population.
Methods: We investigated a total of 65,686 hypertensive patients without DM from 2004 to 2014. Patients with hemoglobin (Hb) A1c ≤6.0%, fasting blood glucose ≤110mg/dL and no history of diabetes or diabetic treatment were enrolled for analysis. Patients were divided into the ß-blockers group and non-ß-blockers group. Propensity score matched (PSM) analysis using a logistic regression model was performed to adjust for potential confounders. The primary end-point was the cumulative incidence of new-onset DM, defined as a fasting blood glucose ≥126 mg/dl or HbA1c ≥6.5%, and major adverse cardio and cerebral events (MACCE) defined as a composite of total death, nonfatal myocardial infarction and cerebrovascular accidents. We investigated predictors of new-onset DM and MACCE based on two models including clinical risk factors and co-medications, respectively.
Results: Mean follow-up duration was 940.13 ± 703.95 days in the entire group before adjustment. The ß-blockers group had a significantly higher incidence of new-onset DM and MACCE than the non-ß-blockers group. After PSM, analysis of a total 2,284 patients (1,142 pairs, C-statistic=0.752) showed no difference between the two groups in terms of new-onset DM or MACCE. In multivariate analysis after PSM, baseline HbA1c, stroke, heart failure, non-selective ß-blockers and age were independent predictors of new-onset DM. Selective ß1-blockers did not increase new-onset DM after adjustment for other antihypertensive medication and statins.
Conclusions: In the era of newer ß-blockers, selective ß1-blockers were not associated with new-onset DM. More evidence is needed to verify this relationship and the underlying mechanisms.
Author Disclosures: Y. Park: None. S. Rha: None. B. Choi: None. S. Choi: None. J. Byun: None. J. Kang: None. W. Kim: None. J. Choi: None. E. Park: None. S. Park: None. S. Lee: None. H. Li: None. J. Na: None. C. Choi: None. J. Kim: None. H. Lim: None. E. Kim: None. C. Park: None. H. Seo: None. D. Oh: None.
- © 2016 by American Heart Association, Inc.