Читать книгу Practical Cardiovascular Medicine - Elias B. Hanna - Страница 198

Severe PAD was considered a relative contraindication to non-selective β-blockers, because of an initial β₂-blocker vasoconstrictive effect. However, this is no longer a contraindication to β-blockers, as they proved safe in PAD.⁴⁵ Also, PAD patients often die of CAD, and thus, β-blockers are valuable in the PAD setting. Individual responses may vary, so be aware of a potential worsening of severe rest symptoms.

In diabetic patients, metoprolol appears to slightly worsen diabetes control (HbA1c). This is not the case with carvedilol and nebivolol, which should be the preferred β-blockers in diabetic patients (GEMINI trial).⁴⁶