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  1. Article: Carvedilol in the treatment of chronic heart failure: lessons from the Carvedilol Or Metoprolol European Trial.

    Kveiborg, Britt / Major-Petersen, Atheline / Christiansen, Buris / Torp-Pedersen, Christian

    Vascular health and risk management

    2007  Volume 3, Issue 1, Page(s) 31–37

    Abstract: Beta-blockers have been shown to improve survival in patients with chronic heart failure. The effect of different generations of beta blockers has been debated. Both metoprolol and carvedilol have demonstrated beneficial effects in placebo-controlled ... ...

    Abstract Beta-blockers have been shown to improve survival in patients with chronic heart failure. The effect of different generations of beta blockers has been debated. Both metoprolol and carvedilol have demonstrated beneficial effects in placebo-controlled trials. In The Carvedilol Or Metoprolol European Trial (COMET) two beta blockers were compared in a double-blind randomized matter. This is the first direct comparison between metoprolol and carvedilol of long-term effect on survival in patients with chronic heart failure. The all-cause mortality was significantly reduced in the favour of carvedilol. The dose and formulation of metoprolol used in this trial has caused debate, and it has been questioned whether a similar beta1-blockade is obtained in the two intervention groups. At this time there is an unresolved debate as to whether carvedilol is a superior beta-blocker or whether differences in beta1-blockade explained the results of COMET.
    MeSH term(s) Adrenergic beta-Antagonists/therapeutic use ; Carbazoles/therapeutic use ; Europe ; Heart Failure/drug therapy ; Humans ; Metoprolol/therapeutic use ; Propanolamines/therapeutic use ; Randomized Controlled Trials as Topic ; Treatment Outcome
    Chemical Substances Adrenergic beta-Antagonists ; Carbazoles ; Propanolamines ; carvedilol (0K47UL67F2) ; Metoprolol (GEB06NHM23)
    Language English
    Publishing date 2007
    Publishing country New Zealand
    Document type Journal Article ; Research Support, Non-U.S. Gov't ; Review
    ZDB-ID 2186568-1
    ISSN 1178-2048 ; 1176-6344
    ISSN (online) 1178-2048
    ISSN 1176-6344
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  2. Article: Metabolic effects of beta-adrenoceptor antagonists with special emphasis on carvedilol.

    Kveiborg, Britt / Christiansen, Buris / Major-Petersen, Atheline / Torp-Pedersen, Christian

    American journal of cardiovascular drugs : drugs, devices, and other interventions

    2005  Volume 6, Issue 4, Page(s) 209–217

    Abstract: Although beta-adrenoceptor antagonists (beta-blockers) have effects on metabolism via their mechanism as blockers of adrenergic stimulation, most interest in the metabolic effects of beta-blockers is caused by their effect on glucose metabolism. Strict ... ...

    Abstract Although beta-adrenoceptor antagonists (beta-blockers) have effects on metabolism via their mechanism as blockers of adrenergic stimulation, most interest in the metabolic effects of beta-blockers is caused by their effect on glucose metabolism. Strict metabolic control and management of cardiovascular risk factors in patients with diabetes mellitus has proven to be of great importance in the improvement of prognosis. Beta-blockers are necessary tools for the treatment of heart failure and hypertension. The use of beta-blockers in patients with diabetes mellitus has been controversial because of fear of deterioration of metabolic control of glucose and lipids and blunting of the symptoms of hypoglycemia. Currently, it appears that there is a beneficial metabolic effect with the third-generation beta-blocker carvedilol. Comparisons have been made between the second-generation beta-blocker metoprolol and carvedilol, with a clear advantage for carvedilol in terms of metabolic control. In the GEMINI (Glycemic Effects in Diabetes Mellitus: Carvedilol-Metoprolol Comparison in Hypertensives) trial, a decrease of 9.1% (p = 0.004) in insulin resistance, compared with baseline values, was seen in patients treated with carvedilol, whereas no significant difference was seen in the group of patients treated with metoprolol. Additionally, an increase in glycosylated hemoglobin of 0.15% from baseline was seen in the metoprolol group (p < 0.001) compared with no significant change in the carvedilol group. These findings indicate that, as carvedilol exerts favorable effects on glucose metabolism compared with metoprolol, patients with diabetes mellitus could benefit from treatment with carvedilol rather than metoprolol. The mechanisms behind these findings are not yet fully understood. Several mechanisms have been suggested, and special interest has been paid to the investigation of the potential beneficial role of the beta2- and alpha1-adrenoceptor-blocking effects of carvedilol, along with its known antioxidant properties.
    MeSH term(s) Adrenergic beta-Antagonists/adverse effects ; Adrenergic beta-Antagonists/pharmacology ; Animals ; Carbazoles/pharmacology ; Diabetes Mellitus/metabolism ; Glucose/metabolism ; Humans ; Insulin Resistance ; Metoprolol/pharmacology ; Propanolamines/pharmacology
    Chemical Substances Adrenergic beta-Antagonists ; Carbazoles ; Propanolamines ; carvedilol (0K47UL67F2) ; Metoprolol (GEB06NHM23) ; Glucose (IY9XDZ35W2)
    Language English
    Publishing date 2005-10-01
    Publishing country New Zealand
    Document type Journal Article ; Research Support, Non-U.S. Gov't ; Review
    ZDB-ID 2052547-3
    ISSN 1179-187X ; 1175-3277
    ISSN (online) 1179-187X
    ISSN 1175-3277
    DOI 10.2165/00129784-200606040-00001
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    In stock of ZB MED Cologne/Königswinter

    Zs.A 5487: Show issues Location:
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    Jg. 1995 - 2021: Lesesall (2.OG)
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  3. Article ; Online: Ingestion of broccoli sprouts does not improve endothelial function in humans with hypertension.

    Christiansen, Buris / Bellostas Muguerza, Natalia / Petersen, Atheline Major / Kveiborg, Britt / Madsen, Christian Rask / Thomas, Hermann / Ihlemann, Nikolaj / Sørensen, Jens Christian / Køber, Lars / Sørensen, Hilmer / Torp-Pedersen, Christian / Domínguez, Helena

    PloS one

    2010  Volume 5, Issue 8, Page(s) e12461

    Abstract: Unlabelled: Ingestion of glucosinolates has previously been reported to improve endothelial function in spontaneously hypertensive rats, possibly because of an increase in NO availability in the endothelium due to an attenuation of oxidative stress; in ... ...

    Abstract Unlabelled: Ingestion of glucosinolates has previously been reported to improve endothelial function in spontaneously hypertensive rats, possibly because of an increase in NO availability in the endothelium due to an attenuation of oxidative stress; in our study we tried to see if this also would be the case in humans suffering from essential hypertension.
    Methods: 40 hypertensive individuals without diabetes and with normal levels of cholesterol were examined. The participants were randomized either to ingest 10 g dried broccoli sprouts, a natural donor of glucosinolates with high in vitro antioxidative potential, for a 4 week period or to continue their ordinary diet and act as controls. Blood pressure, endothelial function measured by flow mediated dilation (FMD) and blood samples were obtained from the participants every other week and the content of glucosinolates was measured before and after the study. Measurements were blinded to treatment allocation.
    Results: In the interventional group overall FMD increased from 4% to 5.8% in the interventional group whereas in the control group FMD was stable (4% at baseline and 3.9% at the end of the study). The change in FMD in the interventional group was mainly due to a marked change in FMD in two participants while the other participants did not have marked changes in FMD. The observed differences were not statistically significant. Likewise significant changes in blood pressure or blood samples were not detected between or within groups. Diastolic blood pressure stayed essentially unchanged in both groups, while the systolic blood pressure showed a small non significant decrease (9 mm Hg) in the interventional group from a value of 153 mm Hg at start.
    Conclusion: Daily ingestion of 10 g dried broccoli sprouts does not improve endothelial function in the presence of hypertension in humans.
    Trial registration: Clinicaltrials.gov NCT00252018.
    MeSH term(s) Adult ; Aged ; Blood Circulation ; Blood Pressure ; Brassica/chemistry ; Eating ; Endothelium, Vascular/pathology ; Female ; Glucosinolates/analysis ; Humans ; Hypertension/pathology ; Hypertension/physiopathology ; Male ; Middle Aged ; Vasodilation
    Chemical Substances Glucosinolates
    Language English
    Publishing date 2010-08-27
    Publishing country United States
    Document type Journal Article ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
    ISSN 1932-6203
    ISSN (online) 1932-6203
    DOI 10.1371/journal.pone.0012461
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  4. Article ; Online: Metoprolol compared to carvedilol deteriorates insulin-stimulated endothelial function in patients with type 2 diabetes - a randomized study.

    Kveiborg, Britt / Hermann, Thomas S / Major-Pedersen, Atheline / Christiansen, Buris / Rask-Madsen, Christian / Raunsø, Jakob / Køber, Lars / Torp-Pedersen, Christian / Dominguez, Helena

    Cardiovascular diabetology

    2010  Volume 9, Page(s) 21

    Abstract: Aim: Studies of beta blockade in patients with type 2 diabetes have shown inferiority of metoprolol treatment compared to carvedilol on indices of insulin resistance. The aim of this study was to examine the effect of metoprolol versus carvedilol on ... ...

    Abstract Aim: Studies of beta blockade in patients with type 2 diabetes have shown inferiority of metoprolol treatment compared to carvedilol on indices of insulin resistance. The aim of this study was to examine the effect of metoprolol versus carvedilol on endothelial function and insulin-stimulated endothelial function in patients with type 2 diabetes.
    Method: 24 patients with type 2 diabetes were randomized to receive either 200 mg metoprolol succinate or 50 mg carvedilol daily. Endothelium-dependent vasodilation was assessed by using venous occlusion plethysmography with increasing doses of intra-arterial infusions of the agonist serotonin. Insulin-stimulated endothelial function was assessed after co-infusion of insulin for sixty minutes. Vaso-reactivity studies were done before and after the two-month treatment period.
    Results: Insulin-stimulated endothelial function was deteriorated after treatment with metoprolol, the percentage change in forearm blood-flow was 60.19% +/- 17.89 (at the highest serotonin dosages) before treatment and -33.80% +/- 23.38 after treatment (p = 0.007). Treatment with carvedilol did not change insulin-stimulated endothelial function. Endothelium-dependent vasodilation without insulin was not changed in either of the two treatment groups.
    Conclusion: This study shows that vascular insulin sensitivity was preserved during treatment with carvedilol while blunted during treatment with metoprolol in patients with type 2 diabetes.
    Trial registration: Current Controlled Trials NCT00497003.
    MeSH term(s) Adrenergic beta-Antagonists/adverse effects ; Adrenergic beta-Antagonists/therapeutic use ; Carbazoles/adverse effects ; Carbazoles/therapeutic use ; Carvedilol ; Denmark ; Diabetes Mellitus, Type 2/blood ; Diabetes Mellitus, Type 2/drug therapy ; Diabetes Mellitus, Type 2/physiopathology ; Dose-Response Relationship, Drug ; Endothelium, Vascular/drug effects ; Endothelium, Vascular/physiopathology ; Female ; Forearm/blood supply ; Humans ; Hypoglycemic Agents/therapeutic use ; Infusions, Intra-Arterial ; Insulin/therapeutic use ; Insulin Resistance ; Male ; Metoprolol/adverse effects ; Metoprolol/therapeutic use ; Middle Aged ; Nitroprusside/administration & dosage ; Photoplethysmography ; Propanolamines/adverse effects ; Propanolamines/therapeutic use ; Regional Blood Flow ; Serotonin/administration & dosage ; Time Factors ; Treatment Outcome ; Vasodilation/drug effects ; Vasodilator Agents/administration & dosage
    Chemical Substances Adrenergic beta-Antagonists ; Carbazoles ; Hypoglycemic Agents ; Insulin ; Propanolamines ; Vasodilator Agents ; Carvedilol (0K47UL67F2) ; Nitroprusside (169D1260KM) ; Serotonin (333DO1RDJY) ; Metoprolol (GEB06NHM23)
    Language English
    Publishing date 2010-05-25
    Publishing country England
    Document type Comparative Study ; Journal Article ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
    ISSN 1475-2840
    ISSN (online) 1475-2840
    DOI 10.1186/1475-2840-9-21
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  5. Article ; Online: Metoprolol compared to carvedilol deteriorates insulin-stimulated endothelial function in patients with type 2 diabetes - a randomized study

    Raunsø Jakob / Rask-Madsen Christian / Christiansen Buris / Major-Pedersen Atheline / Hermann Thomas S / Kveiborg Britt / Køber Lars / Torp-Pedersen Christian / Dominguez Helena

    Cardiovascular Diabetology, Vol 9, Iss 1, p

    2010  Volume 21

    Abstract: Abstract Aim Studies of beta blockade in patients with type 2 diabetes have shown inferiority of metoprolol treatment compared to carvedilol on indices of insulin resistance. The aim of this study was to examine the effect of metoprolol versus carvedilol ...

    Abstract Abstract Aim Studies of beta blockade in patients with type 2 diabetes have shown inferiority of metoprolol treatment compared to carvedilol on indices of insulin resistance. The aim of this study was to examine the effect of metoprolol versus carvedilol on endothelial function and insulin-stimulated endothelial function in patients with type 2 diabetes. Method 24 patients with type 2 diabetes were randomized to receive either 200 mg metoprolol succinate or 50 mg carvedilol daily. Endothelium-dependent vasodilation was assessed by using venous occlusion plethysmography with increasing doses of intra-arterial infusions of the agonist serotonin. Insulin-stimulated endothelial function was assessed after co-infusion of insulin for sixty minutes. Vaso-reactivity studies were done before and after the two-month treatment period. Results Insulin-stimulated endothelial function was deteriorated after treatment with metoprolol, the percentage change in forearm blood-flow was 60.19% ± 17.89 (at the highest serotonin dosages) before treatment and -33.80% ± 23.38 after treatment (p = 0.007). Treatment with carvedilol did not change insulin-stimulated endothelial function. Endothelium-dependent vasodilation without insulin was not changed in either of the two treatment groups. Conclusion This study shows that vascular insulin sensitivity was preserved during treatment with carvedilol while blunted during treatment with metoprolol in patients with type 2 diabetes. Trial registration Current Controlled Trials NCT00497003
    Keywords Diseases of the circulatory (Cardiovascular) system ; RC666-701 ; Specialties of internal medicine ; RC581-951 ; Internal medicine ; RC31-1245 ; Medicine ; R ; DOAJ:Cardiovascular ; DOAJ:Medicine (General) ; DOAJ:Health Sciences
    Language English
    Publishing date 2010-05-01T00:00:00Z
    Publisher BioMed Central
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  6. Article ; Online: Ingestion of broccoli sprouts does not improve endothelial function in humans with hypertension.

    Buris Christiansen / Natalia Bellostas Muguerza / Atheline Major Petersen / Britt Kveiborg / Christian Rask Madsen / Hermann Thomas / Nikolaj Ihlemann / Jens Christian Sørensen / Lars Køber / Hilmer Sørensen / Christian Torp-Pedersen / Helena Domínguez

    PLoS ONE, Vol 5, Iss 8, p e

    2010  Volume 12461

    Abstract: Ingestion of glucosinolates has previously been reported to improve endothelial function in spontaneously hypertensive rats, possibly because of an increase in NO availability in the endothelium due to an attenuation of oxidative stress; in our study we ... ...

    Abstract Ingestion of glucosinolates has previously been reported to improve endothelial function in spontaneously hypertensive rats, possibly because of an increase in NO availability in the endothelium due to an attenuation of oxidative stress; in our study we tried to see if this also would be the case in humans suffering from essential hypertension.40 hypertensive individuals without diabetes and with normal levels of cholesterol were examined. The participants were randomized either to ingest 10 g dried broccoli sprouts, a natural donor of glucosinolates with high in vitro antioxidative potential, for a 4 week period or to continue their ordinary diet and act as controls. Blood pressure, endothelial function measured by flow mediated dilation (FMD) and blood samples were obtained from the participants every other week and the content of glucosinolates was measured before and after the study. Measurements were blinded to treatment allocation.In the interventional group overall FMD increased from 4% to 5.8% in the interventional group whereas in the control group FMD was stable (4% at baseline and 3.9% at the end of the study). The change in FMD in the interventional group was mainly due to a marked change in FMD in two participants while the other participants did not have marked changes in FMD. The observed differences were not statistically significant. Likewise significant changes in blood pressure or blood samples were not detected between or within groups. Diastolic blood pressure stayed essentially unchanged in both groups, while the systolic blood pressure showed a small non significant decrease (9 mm Hg) in the interventional group from a value of 153 mm Hg at start.Daily ingestion of 10 g dried broccoli sprouts does not improve endothelial function in the presence of hypertension in humans.Clinicaltrials.gov NCT00252018.
    Keywords Medicine ; R ; Science ; Q
    Subject code 630
    Language English
    Publishing date 2010-08-01T00:00:00Z
    Publisher Public Library of Science (PLoS)
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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