{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T22:36:49Z","timestamp":1784932609399,"version":"3.55.0"},"reference-count":33,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2021,6,14]],"date-time":"2021-06-14T00:00:00Z","timestamp":1623628800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pharmacoepidemiology and Drug"],"published-print":{"date-parts":[[2021,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Although prior literature suggests that metoprolol may worsen glucose control compared to carvedilol, whether this has clinical relevance among older adults with diabetes and heart failure (HF) remains an open question.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a US retrospective cohort study utilizing data sourced from a 50% national sample of Medicare fee\u2010for\u2010service claims of patients with part D prescription drug coverage (2007\u20132017). Among patients with diabetes and HF, we identified initiators of metoprolol or carvedilol, which were 1:1 propensity score matched on &gt;90 variables. The primary outcome was initiation of a new oral or injectable antidiabetic medication (proxy for uncontrolled diabetes); secondary outcomes included initiation of insulin and severe hyperglycemic event (composite of emergency room visits or hospitalizations related to hyperglycemia).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 24\u2009239 propensity score\u2013matched pairs (mean [SD] age 77.7 [8.0] years; male [39.1%]), there were 8150 (incidence rate per 100 person\u2010years [IR]\u00a0=\u00a033.5) episodes of antidiabetic medication initiation among metoprolol users (exposure arm) compared to 8576 (IR\u00a0=\u00a033.4) among carvedilol users (comparator arm) compared to corresponding to an adjusted hazard ratio (aHR) of 0.97 (95% confidence interval [CI]: 0.94, 1.01). Similarly, metoprolol was not associated with a significant increase in the risk of secondary outcomes including insulin initiation: aHR of 0.98 (95% CI: 0.93, 1.04) and severe hyperglycemic events: aHR of 0.98 (95% CI: 0.93, 1.02).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In this large study of older adults with HF and diabetes, initiation of metoprolol compared to carvedilol was not associated with an increase in the risk of clinically relevant hyperglycemia.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pds.5303","type":"journal-article","created":{"date-parts":[[2021,6,9]],"date-time":"2021-06-09T00:19:25Z","timestamp":1623197965000},"page":"1420-1427","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Risk of clinically relevant hyperglycemia with metoprolol compared to carvedilol in older adults with heart failure and diabetes"],"prefix":"10.1002","volume":"30","author":[{"given":"Chintan V.","family":"Dave","sequence":"first","affiliation":[{"name":"Center for Pharmacoepidemiology and Treatment Science Institute for Health, Health Care Policy and Aging Research, Rutgers University  New Brunswick New Jersey USA"},{"name":"Department of Pharmacy Practice and Administration, Ernest Mario School of Pharmacy Rutgers University  Piscataway New Jersey USA"},{"name":"Department of Veterans Affairs\u2010New Jersey Health Care System  East Orange New Jersey USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian L.","family":"Strom","sequence":"additional","affiliation":[{"name":"Center for Pharmacoepidemiology and Treatment Science Institute for Health, Health Care Policy and Aging Research, Rutgers University  New Brunswick New Jersey USA"},{"name":"Rutgers Biomedical and Health Sciences  Stratford New Jersey USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fred A.","family":"Kobylarz","sequence":"additional","affiliation":[{"name":"Department of Family Medicine and Community Health, Geriatrics Program, Robert Wood Johnson Medical School Rutgers University Biomedical and Health Sciences  New Brunswick New Jersey USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel B.","family":"Horton","sequence":"additional","affiliation":[{"name":"Center for Pharmacoepidemiology and Treatment Science Institute for Health, Health Care Policy and Aging Research, Rutgers University  New Brunswick New Jersey USA"},{"name":"Department of Pediatrics, Rutgers Robert Wood Johnson Medical School  New Brunswick New Jersey USA"},{"name":"Department of Biostatistics and Epidemiology Rutgers School of Public Health  Piscataway New Jersey USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8598-5771","authenticated-orcid":false,"given":"Tobias","family":"Gerhard","sequence":"additional","affiliation":[{"name":"Center for Pharmacoepidemiology and Treatment Science Institute for Health, Health Care Policy and Aging Research, Rutgers University  New Brunswick New Jersey USA"},{"name":"Department of Pharmacy Practice and Administration, Ernest Mario School of Pharmacy Rutgers University  Piscataway New Jersey USA"},{"name":"Department of Biostatistics and Epidemiology Rutgers School of Public Health  Piscataway New Jersey USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chin\u2010Lin","family":"Tseng","sequence":"additional","affiliation":[{"name":"Department of Veterans Affairs\u2010New Jersey Health Care System  East Orange New Jersey USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ilja","family":"Dejanovic","sequence":"additional","affiliation":[{"name":"Department of Medicine Rutgers Robert Wood Johnson Medical School  New Brunswick New Jersey USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abner","family":"Nyandege","sequence":"additional","affiliation":[{"name":"Center for Pharmacoepidemiology and Treatment Science Institute for Health, Health Care Policy and Aging Research, Rutgers University  New Brunswick New Jersey USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soko","family":"Setoguchi","sequence":"additional","affiliation":[{"name":"Center for Pharmacoepidemiology and Treatment Science Institute for Health, Health Care Policy and Aging Research, Rutgers University  New Brunswick New Jersey USA"},{"name":"Department of Biostatistics and Epidemiology Rutgers School of Public Health  Piscataway New Jersey USA"},{"name":"Department of Medicine Rutgers Robert Wood Johnson Medical School  New Brunswick New Jersey USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,6,14]]},"reference":[{"key":"e_1_2_8_2_1","unstructured":"Control CfD Prevention. 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