The effects of celiprolol in the short-term treatment of hypertensive patients with type 2 diabetes

The aim of this study was to evaluate the clinical efficacy and metabolic effects of celiprolol, a new beta₁-selective beta-blocker with beta₂-agonist and alpha₂-antagonist properties, in the treatment of hypertensive patients with type 2 diabetes. After a four-week placebo run-in period, ten patients with mild hypertension and type 2 diabetes, seven men and three women, aged 53 to 66 years, were treated with celiprolol 200 mg once daily for three months, with no change in previous antidiabetic therapy. Supine and standing systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate, fasting and postprandial glycemia, and 24-hour glucose urinary excretion were determined monthly. Glycosylated hemoglobin, plasma C-peptide microalbuminuria, serum creatinine, urea, electrolytes, uric acid, total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), and triglycerides (TG) were evaluated before and after three months of therapy. Celiprolol significantly reduced both supine and standing SBP and DBP without adversely affecting glucose or lipid metabolism or the other laboratory parameters. We observed a trend towards a reduction in TC and TG and an increase in HDL-C. None of the patients required changes in the dosage of oral hypoglycemic drugs. No relevant side effect was reported. In conclusion, celiprolol was effective and well-tolerated in the treatment of hypertensive patients with associated type 2 diabetes; the lack of adverse effects on glucose homeostasis coupled with its favorable impact on lipid profile makes it an interesting drug in these patients.