Beta-Rezeptorenblocker und ACE-Hemmer

Zusammenfassung

Nahezu alle Typ-2-Diabetiker leiden an einer arteriellen Hypertonie, die in der Regel noch vor dem Diabetes manifest wird. Die konsequente Einstellung der arteriellen Hypertonie erfordert häufig eine Zweifachkombination aus Angiotensin Converting Enzyme(ACE)-Hemmer und β-Rezeptorenblocker. Metoprolol ist der häufigste verwendete β-Blocker. Klinische Studien weisen auf eine Überlegenheit von Carvedilol bezüglich der Qualität der Stoffwechseleinstellung und der Vermeidung von Folgestörungen des Diabetes hin. Daher scheint Carvedilol der β-Rezeptorenblocker der Wahl für Patienten mit hohem kardiovaskulären Risiko und insbesondere Typ-2-Diabetiker zu sein. Wegen fehlender Vergleiche zu Metoprolol-Succinat sowie zu optimal dosiertem Metoprolol-Tartrat kann aber nicht von einer sicheren Überlegenheit von Carvedilol ausgegangen werden.

Summary

Nearly all type 2 diabetic patients are suffering from arterial hypertension. The latter usually becomes manifest earlier than the diabetic metabolic disturbances. Adequate treatment often requires a combination of angiotensin converting enzyme(ACE)-inhibitors and β-adrenoceptor antagonists. Metoprolol is still the most frequently used β-adrenoceptor antagonist in this setting. Some clinical trials have shown carvedilol to be superior in improving the metabolic situation and prevention of secondary disorders caused by diabetes. Therefore carvedilol may be the β-adrenoceptor antagonist of choice for treatment of patients at high cardiovascular risk and especially for diabetes type 2. As comparisons to metoprolol succinate as well as to optimally dosed metoprolol tartrate are missing, a definite superiority of carvedilol cannot be assumed.

Diabetes - arterielle Hypertonie - β-Blocker - Metoprolol - Carvedilol

diabetes - arterial hypertension - β-adrenoceptor antagonists - metoprolol - carvedilol

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