Expert: Time to break the beta blocker habit?

Dr. Ragavendra Baliga, a cardiologist at the Ohio State University Wexner Medical Center examines a patient. Millions of people take Beta Blockers for everything from heart disease to stage fright, from treating glaucoma to preventing migraines. But not all beta blockers are created equal. Studies show, over time, taking an older class of beta blockers can substantially increase your risk of developing diabetes. Dr. Ragavendra Baliga is helping to lead the charge to do away with the older versions of this popular medicine. Credit: Ohio State University Wexner Medical Center

First developed in the 1950s, beta blockers have been a mainstay in medicine for decades, used to treat everything from heart disease to stage fright to glaucoma. But some older classes of beta blockers are causing new concerns.

"Studies show that older beta blockers can increase a patient's risk of diabetes by more than 25 percent," said Dr. Ragavendra Baliga, a at The Ohio State University Wexner Medical Center. "So, I am actually switching many of my patients to a 'newer' beta-blocker, which is less likely to cause diabetes while proving just as effective in treating heart failure and other conditions," he said.

Baliga recently published an editorial on the topic in Clinics of North America, in which he suggests that perhaps it's time to break tradition of long-term use of some beta-blockers.

"The older beta-blockers are double-edged swords," he said. "They save lives, but you want to avoid complications down the road, like diabetes."

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Credit: Ohio State University Wexner Medical Center

That's a message that hits especially close to home for Mark Bero. Recently diagnosed with an , Bero was prescribed beta blockers. "So far it's worked wonderfully for me," said Bero. "Beta blockers are keeping my heart healthy and I feel great."

But if anyone knows the risks and dangers of diabetes, it's Bero. "I had a younger brother with diabetes, who had complications. He went into a diabetic coma and he never came out of it," he said.

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Credit: Ohio State University Wexner Medical Center

Knowing his family history, and growing concerns over the extended use of some beta blockers, Bero and his doctor are keeping a close eye on his condition.

"Diabetes can creep up on you very slowly, even before you know it," said Baliga. "Down the road, diabetes will likely cause more heart attacks, more strokes, more and a variety of conditions," said Baliga.

"The newer classes of beta blockers seem to reduce those risks," said Baliga, a message he is hoping to get out to patients and doctors alike. "We need to be very vigilant about medications we're taking for our conditions," he said. "The last thing we want to do is to treat one condition and risk another."

Baliga says you should never switch medications without talking to you doctor first, but if you are taking , you may want to discuss the class of drug your taking and the risks that may be involved.

More information: β-Blockers in Heart Failure: Breaking Tradition to Avoid Diabetes? Heart Failure Clinics, Volume 8, Issue 4, October 2012. Online: www.sciencedirect.com/science/… ii/S1551713612000748

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tekram
not rated yet Nov 12, 2012
http://download.j...0748.pdf
Free article: This study suggests that traditional b-blockers make insulin sensitivity worse, whereas vasodilating b-blockers may have a beneficial effect. Small studies have shown that carvedilol improves insulin sensitivity compared to metoprolol 20 and atenolol. 21