Lowering blood pressure with beta-blockers in combination with other renin-angiotensin system blockers in patients with hypertension and type 2 diabetes: results from the GEMINI Trial.

Jackson T. Wright, George L. Bakris, David S H Bell, Vivian Fonseca, Richard E. Katholi, Janet B. McGill, Franz H. Messerli, Robert A. Phillips, Philip Raskin, Fred K. Holdbrook, Mary Ann Lukas, Malini Iyengar

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

The effects of beta-blockade in addition to more specific renin-angiotensin system (RAS) blockers on blood pressure (BP) in patients with diabetes are described. After washout of medications other than angiotensin-converting enzyme inhibitors and angiotensin receptor blockers, patients were titrated to a BP level <130/80 mm Hg using therapy with carvedilol 6.25 to 25 mg bid (n=498) or metoprolol tartrate 50 to 200 mg bid (n=737). At the end of the beta-blocker titration period, a BP level <130/80 mm Hg was achieved in 37% of carvedilol-treated and 36% of metoprolol-treated participants who continued to receive a renin-angiotensin system blocker. In the approximately 60% of participants in whom a BP level <130/80 mm Hg was not attained with renin-angiotensin system blockade plus beta-blockade, hydrochlorothiazide was added in 43% and 44% of carvedilol and metoprolol groups, respectively; 25% (both arms) also required a calcium channel blocker. Among those in whom goal BP was not achieved, 42% of carvedilol- and 40% of metoprolol-treated participants were not titrated to the highest dose of beta-blocker. The use of carvedilol compared with metoprolol did not effect glycemic control.

Original languageEnglish (US)
Pages (from-to)842-849
Number of pages8
JournalJournal of clinical hypertension (Greenwich, Conn.)
Volume9
Issue number11
StatePublished - Nov 2007

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Metoprolol
Renin-Angiotensin System
Type 2 Diabetes Mellitus
Blood Pressure
Hypertension
Hydrochlorothiazide
Angiotensin Receptor Antagonists
Calcium Channel Blockers
Angiotensin-Converting Enzyme Inhibitors
carvedilol

ASJC Scopus subject areas

  • Internal Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Lowering blood pressure with beta-blockers in combination with other renin-angiotensin system blockers in patients with hypertension and type 2 diabetes : results from the GEMINI Trial. / Wright, Jackson T.; Bakris, George L.; Bell, David S H; Fonseca, Vivian; Katholi, Richard E.; McGill, Janet B.; Messerli, Franz H.; Phillips, Robert A.; Raskin, Philip; Holdbrook, Fred K.; Lukas, Mary Ann; Iyengar, Malini.

In: Journal of clinical hypertension (Greenwich, Conn.), Vol. 9, No. 11, 11.2007, p. 842-849.

Research output: Contribution to journalArticle

Wright, JT, Bakris, GL, Bell, DSH, Fonseca, V, Katholi, RE, McGill, JB, Messerli, FH, Phillips, RA, Raskin, P, Holdbrook, FK, Lukas, MA & Iyengar, M 2007, 'Lowering blood pressure with beta-blockers in combination with other renin-angiotensin system blockers in patients with hypertension and type 2 diabetes: results from the GEMINI Trial.', Journal of clinical hypertension (Greenwich, Conn.), vol. 9, no. 11, pp. 842-849.
Wright, Jackson T. ; Bakris, George L. ; Bell, David S H ; Fonseca, Vivian ; Katholi, Richard E. ; McGill, Janet B. ; Messerli, Franz H. ; Phillips, Robert A. ; Raskin, Philip ; Holdbrook, Fred K. ; Lukas, Mary Ann ; Iyengar, Malini. / Lowering blood pressure with beta-blockers in combination with other renin-angiotensin system blockers in patients with hypertension and type 2 diabetes : results from the GEMINI Trial. In: Journal of clinical hypertension (Greenwich, Conn.). 2007 ; Vol. 9, No. 11. pp. 842-849.
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abstract = "The effects of beta-blockade in addition to more specific renin-angiotensin system (RAS) blockers on blood pressure (BP) in patients with diabetes are described. After washout of medications other than angiotensin-converting enzyme inhibitors and angiotensin receptor blockers, patients were titrated to a BP level <130/80 mm Hg using therapy with carvedilol 6.25 to 25 mg bid (n=498) or metoprolol tartrate 50 to 200 mg bid (n=737). At the end of the beta-blocker titration period, a BP level <130/80 mm Hg was achieved in 37{\%} of carvedilol-treated and 36{\%} of metoprolol-treated participants who continued to receive a renin-angiotensin system blocker. In the approximately 60{\%} of participants in whom a BP level <130/80 mm Hg was not attained with renin-angiotensin system blockade plus beta-blockade, hydrochlorothiazide was added in 43{\%} and 44{\%} of carvedilol and metoprolol groups, respectively; 25{\%} (both arms) also required a calcium channel blocker. Among those in whom goal BP was not achieved, 42{\%} of carvedilol- and 40{\%} of metoprolol-treated participants were not titrated to the highest dose of beta-blocker. The use of carvedilol compared with metoprolol did not effect glycemic control.",
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