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Antiatherosclerotic effects of beta-blockers

Wikstrand, J; Berglund, Göran LU ; Hedblad, Bo LU and Hulthe, J (2003) In American Journal of Cardiology 91(12, Suppl. 1). p.25-29
Abstract
Accumulating data from studies in animals and humans indicate that beta-blockade has antiatherosclerotic effects. To date, 2 long-term ultrasound studies provide the strongest evidence. The Beta-Blocker Cholesterol-Lowering Asymptomatic Plaque Study (BCAPS) trial reported favorable effects with beta-blockade on early stages of atherosclerosis in patients with carotid plaque but no symptoms of carotid artery disease. Compared with placebo, metoprolol controlled release/extended release (CR/XL) 25 mg once daily significantly reduced plaque thickness after 18 months of treatment (net difference -0.058 mm/year; p <0.001) and at 3 years' follow-up (net difference -0.023 mm/year; p = 0.018). The Effects of Long-Term Treatment of Metoprolol... (More)
Accumulating data from studies in animals and humans indicate that beta-blockade has antiatherosclerotic effects. To date, 2 long-term ultrasound studies provide the strongest evidence. The Beta-Blocker Cholesterol-Lowering Asymptomatic Plaque Study (BCAPS) trial reported favorable effects with beta-blockade on early stages of atherosclerosis in patients with carotid plaque but no symptoms of carotid artery disease. Compared with placebo, metoprolol controlled release/extended release (CR/XL) 25 mg once daily significantly reduced plaque thickness after 18 months of treatment (net difference -0.058 mm/year; p <0.001) and at 3 years' follow-up (net difference -0.023 mm/year; p = 0.018). The Effects of Long-Term Treatment of Metoprolol CR/XL on Surrogate Variables for Atherosclerotic Disease (ELVA) trial demonstrated that β-blockers and statins affect different mechanisms in the atherosclerotic process and have additive beneficial effects. Patients with hypercholesterolemia were randomized to metoprolol CR/XL 100 mg once daily or placebo once daily and concomitant statin therapy. The metoprolol CR/XL group had a significantly lower rate of progression of the composite carotid bulb intima-media thickness (IMT) plus common carotid IMT than the placebo group, both at I year (-0.08 vs -0.01 mm; p = 0.004) and after 3 years' follow-up (-0.06 vs +0.03 mm; p = 0.011). Several factors may contribute to the mechanism of benefit in these trials, including reduced sympathetic activity, improved hemodynamic parameters, and direct effects on the vascular enclothelium. (C) 2003 by Excerpta Medica, Inc. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
American Journal of Cardiology
volume
91
issue
12, Suppl. 1
pages
25 - 29
publisher
Excerpta Medica
external identifiers
  • wos:000183772500005
  • pmid:12818732
  • scopus:0038344675
ISSN
1879-1913
DOI
10.1016/S0002-9149(03)00431-4
language
English
LU publication?
yes
id
8d3c4add-fbf1-4f9a-b8f0-bb397b0a6c58 (old id 308325)
date added to LUP
2007-09-24 08:52:05
date last changed
2018-01-07 05:44:20
@article{8d3c4add-fbf1-4f9a-b8f0-bb397b0a6c58,
  abstract     = {Accumulating data from studies in animals and humans indicate that beta-blockade has antiatherosclerotic effects. To date, 2 long-term ultrasound studies provide the strongest evidence. The Beta-Blocker Cholesterol-Lowering Asymptomatic Plaque Study (BCAPS) trial reported favorable effects with beta-blockade on early stages of atherosclerosis in patients with carotid plaque but no symptoms of carotid artery disease. Compared with placebo, metoprolol controlled release/extended release (CR/XL) 25 mg once daily significantly reduced plaque thickness after 18 months of treatment (net difference -0.058 mm/year; p &lt;0.001) and at 3 years' follow-up (net difference -0.023 mm/year; p = 0.018). The Effects of Long-Term Treatment of Metoprolol CR/XL on Surrogate Variables for Atherosclerotic Disease (ELVA) trial demonstrated that β-blockers and statins affect different mechanisms in the atherosclerotic process and have additive beneficial effects. Patients with hypercholesterolemia were randomized to metoprolol CR/XL 100 mg once daily or placebo once daily and concomitant statin therapy. The metoprolol CR/XL group had a significantly lower rate of progression of the composite carotid bulb intima-media thickness (IMT) plus common carotid IMT than the placebo group, both at I year (-0.08 vs -0.01 mm; p = 0.004) and after 3 years' follow-up (-0.06 vs +0.03 mm; p = 0.011). Several factors may contribute to the mechanism of benefit in these trials, including reduced sympathetic activity, improved hemodynamic parameters, and direct effects on the vascular enclothelium. (C) 2003 by Excerpta Medica, Inc.},
  author       = {Wikstrand, J and Berglund, Göran and Hedblad, Bo and Hulthe, J},
  issn         = {1879-1913},
  language     = {eng},
  number       = {12, Suppl. 1},
  pages        = {25--29},
  publisher    = {Excerpta Medica},
  series       = {American Journal of Cardiology},
  title        = {Antiatherosclerotic effects of beta-blockers},
  url          = {http://dx.doi.org/10.1016/S0002-9149(03)00431-4},
  volume       = {91},
  year         = {2003},
}