Abstract
Objective
To assess the relationship between use of β-blockers and all-cause mortality in patients
with and without diabetes.
Patients and Methods
Using data from the US National Health and Nutrition Examination Survey 1999-2010,
we conducted a prospective cohort study. The study participants were followed-up from
the survey participation date until December 31, 2011. We used a Cox proportional
hazards model for all-cause mortality analysis. The multivariate-adjusted hazard ratios
(HRs) of the participants taking β-blockers were compared with those of the participants
not taking β-blockers.
Results
This study included 2840 diabetic participants and 14,684 nondiabetic participants.
Compared with diabetic participants not taking a β-blocker, all-cause mortality was
significantly higher in diabetic participants taking any β-blocker (HR, 1.49; 95%
CI, 1.09-2.04; P=.01), taking a β1-selective β-blocker (HR, 1.60; 95% CI, 1.13-2.24; P=.007), or taking a specific β-blocker (bisoprolol, metoprolol, and carvedilol) (HR,
1.55; 95% CI, 1.09-2.21; P=.01). In addition, all-cause mortality in diabetic participants with coronary heart
disease (CHD) was significantly higher in those taking beta-blockers, compared with
those not taking beta-blockers (HR, 1.64; 95% CI, 1.08-2.48; P=.02), whereas that in non-diabetic participants with CHD was significantly lower
in those taking beta-blockers (HR, 0.68; 95% CI, 0.50-0.94; P=.02). A propensity score–matched Cox proportional hazards model yielded similar results.
Conclusion
Use of β-blockers may be associated with an increased risk of mortality for patients
with diabetes and among the subset who have CHD.
Abbreviations and Acronyms:
BMI (body mass index), CHD (coronary heart disease), CHF (congestive heart failure), COPD (chronic obstructive pulmonary disease), HbA1c (hemoglobin A1c), HR (hazard ratio), MEC (mobile examination center), NCHS (National Center for Health Statistics), NHANES (National Health and Nutrition Examination Survey)To read this article in full you will need to make a payment
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Article Info
Publication History
Published online: March 12, 2018
Footnotes
For editorial comment, see page 401
Grant Support: This work was supported by grant 26860701 from the Japan Society for the Promotion of Science KAKENHI and a grant from the National Center for Global Health and Medicine.
Potential Competing Interests: The authors report no competing interests.
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