Adding the beta-blocker metoprolol to ACE-inhibitor therapy may improve cardiac autonomic function in type 1 diabetics with albuminuria and high risk of cardiovascular disease.
That is the preliminary finding of E. Ebbehøj and colleagues at the Aarhus University Hospital, in Aarhus Denmark, who studied the effects of adding metoprolol to ACE-inhibitor therapy in the treatment of patients with type 1 diabetes and albuminuria.
Diabetic nephropathy is associated with a high risk of cardiac mortality, including sudden death, which may be related to an imbalance between sympathetic and parasympathetic tone resulting in decreased heart rate variability, the investigators hypothesised. In non-diabetic patients, decreased heart rate variability is known to be a strong predictor of cardiovascular death. Studies in non-diabetic patients have shown that beta-blockers improve heart rate variability parameters that are known to reflect parasympathetic function
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