Drug ups survival in diabetics with heart failure

In people with diabetes and heart failure, treatment with the beta-blocker metoprolol CR/XL (controlled release/extended release) safely reduces the risk of hospitalization and death, research shows.

Concern over lack of benefit and potential harmful effects have prevented many doctors from prescribing beta-blockers for patients with diabetes and heart failure, study investigators note in the American Heart Journal.

As part of a large study, 985 adults with diabetes and 3006 without diabetes were randomly assigned to receive metoprolol or inactive placebo. The subjects, ages 40 to 80, with varying degrees of heart failure, were followed for an average of 1 year.

Metoprolol treatment reduced the risk of hospitalization for heart failure by 37 percent in those with diabetes and by 35 percent in those without diabetes. For those with severe heart failure, metoprolol reduced the risk of hospital admission by 53% in diabetics and by 44% in non-diabetics.

In the diabetic group, the risk of death due to all causes was lowered 18 percent in the metoprolol group. For those with severe heart failure, there was a 29 percent risk reduction in "all-cause" mortality.

Dr. Prakash C. Deedwania of the University of California at San Francisco and co-authors say "it is time to remove existing barriers for the use of beta-blocker treatment in patients with heart failure and diabetes...which should improve their quality of life by decreasing hospitalizations for heart failure, and also increase survival."

SOURCE: American Heart Journal, January 2005.