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β-receptor blockers significantly impact the cardiovascular system by counteracting catecholamine-induced sympathetic responses. These medications decrease heart rate, contractility, and cardiac output, potentially leading to cardiac depression, life-threatening bradycardia, and death. Therapeutically, β-blockers function as mild antihypertensives and are utilized in treating angina pectoris and cardiac arrhythmias. However, nonselective β-blockers inhibit β2-receptors in bronchial smooth...

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Related Experiment Videos

Body weight changes with beta-blocker use: results from GEMINI.

Franz H Messerli¹, David S H Bell, Vivian Fonseca

¹St. Luke's-Roosevelt Hospital Center, New York City, NY 10019, USA. FMesserli@aol.com

The American Journal of Medicine

|July 3, 2007

Summary

Metoprolol tartrate caused significant weight gain in patients with type 2 diabetes and hypertension, unlike carvedilol. This weight gain was more pronounced in obese patients not on insulin therapy.

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Area of Science:

Cardiology
Endocrinology
Pharmacology

Background:

Type 2 diabetes often presents with overweight or obesity, increasing cardiovascular risk.
Beta-blockers are frequently used for hypertension in diabetic patients but may influence weight.
Concerns exist regarding beta-blockers' impact on weight management in high-risk populations.

Purpose of the Study:

To compare the effects of carvedilol and metoprolol tartrate on body weight in patients with type 2 diabetes and hypertension.
To analyze weight changes associated with these beta-blockers within the Glycemic Effect in Diabetes Mellitus: Carvedilol-Metoprolol Comparison in Hypertensives (GEMINI) trial.

Main Methods:

A prespecified secondary analysis of the GEMINI study involving 1106 patients.
Evaluation of body weight changes after a 5-month treatment period.

Main Results:

Metoprolol tartrate was associated with a mean weight gain of 1.19 kg (P <.001), while carvedilol showed no significant change (0.17 kg; P =.36).
The difference in weight change between carvedilol and metoprolol tartrate was -1.02 kg (P <.001).
Greater weight gain with metoprolol tartrate was observed in patients with a BMI >30 kg/m2 and BMI >40 kg/m2 compared to carvedilol.

Conclusions:

Metoprolol tartrate is linked to increased weight gain compared to carvedilol in hypertensive patients with type 2 diabetes.
Weight gain was most significant in patients not receiving insulin therapy.
No significant associations were found between weight change and changes in HbA1c, HOMA-IR, or blood pressure.