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Antihypertensive treatment and new-onset diabetes mellitus
Tonje Amb Aksnes1, Henrik M Reims, Sverre E Kjeldsen
1Clinica Medica, Ospedale S Gerardo, University of Milan-Bicocca, Via Donizetti 106, 200 52 Monza, Italy. giuseppe.mancia@unimib.it.
Abstract:
The various antihypertensive regimens have varying effects on glucose metabolism and the development of diabetes mellitus. Recent large hypertension trials have shown great differences in the development of new-onset diabetes among antihypertensive drug therapies. The incidence of diabetes is unchanged or increased by thiazide diuretics and b-adrenergic blockers, and unchanged or decreased by angiotensin-converting enzyme inhibitors, calcium channel blockers, and angiotensin-receptor blockers. The differences in new-onset diabetes mellitus have not influenced the outcome of cardiovascular mortality and morbidity in all of the large clinical trials, but drug-induced diabetes among hypertensive patients is known to carry the same cardiovascular risk as that seen in patients with previously known diabetes; however, it might take years for the increased risk to become apparent.
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