Issue 185: Item 4: Beta-Blockers Improve Survival Outcomes In Diabetics With He

Therapy improves outcomes for diabetic patients with chronic heart failure, albeit not to the extent realized by patients without diabetes.

Beta-blockers provide substantial benefits to heart failure patients when given with other drugs called ACE inhibitors, the authors explain. However, many doctors are reluctant to give beta-blockers to diabetics out of concern for possible side effects on blood sugar levels.

Dr. Henry Krum from Monash University in Melbourne, Australia, and colleagues analyzed data from six trials of beta-blocker therapy in patients with heart failure, representing more than 13,000 patients. Nearly 25 percent of the patients had diabetes. Among all patients with heart failure, the presence of diabetes increased the death risk by 25 percent, the authors report in the American Heart Journal. However, diabetics treated with beta-blockers were 16 percent less likely to die than diabetics not treated with these drugs.

In patients without diabetes, beta-blocker therapy was tied to a 28 percent drop in the risk of death, the authors note.

The results suggest that beta-blocker therapy reduces the death risk in heart failure patients with diabetes. However, studies specifically focusing on such patients are needed to confirm the current findings, the authors note.

Still, based on the present analysis, it is possible to conclude that heart failure patients, with or without diabetes, should probably receive a beta-blocker unless they have strict reason not to, the researchers state. American Heart Journal, November 2003

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