Antihypertensive agents, insulin sensitivity, and new-onset diabetes
Pantelis A Sarafidis1, Samy I McFarlane, George L Bakris
11st Department of Medicine, AHEPA Hospital, Aristotle University of Thessaloniki, St. Kiriakidi 1, 546 36 Thessaloniki, Greece. psarafidis11@yahoo.gr
Current Diabetes Reports
|June 6, 2007
Summary
Antihypertensive drugs impact carbohydrate metabolism and diabetes risk. While some drugs worsen insulin sensitivity and increase diabetes, others offer neutral or beneficial effects, requiring further research on newer agents and cardiovascular links.
Area of Science:
- Pharmacology
- Endocrinology
- Cardiovascular Medicine
Background:
- The relationship between antihypertensive medications and metabolic health, particularly carbohydrate metabolism and diabetes development, has been extensively studied for over 20 years.
- Numerous clinical and observational studies have explored the impact of various antihypertensive drug classes on insulin sensitivity, glycemic control, and the incidence of new-onset diabetes.
Purpose of the Study:
- To review and evaluate the current scientific understanding of how different antihypertensive drug classes affect carbohydrate metabolism and diabetes risk.
- To identify areas requiring further investigation, including the metabolic profiles of newer antihypertensive agents and their association with cardiovascular risk.
Main Methods:
- Review of existing clinical studies assessing insulin sensitivity and glycemic control.
- Analysis of observational studies and large outcome trials examining the link between antihypertensive agents and diabetes incidence.
Main Results:
- Thiazide diuretics and traditional beta-blockers generally impair insulin sensitivity and elevate the risk of new-onset diabetes.
- Angiotensin-converting enzyme inhibitors, calcium channel blockers, and angiotensin II receptor blockers typically demonstrate neutral or favorable effects on these metabolic parameters.
Conclusions:
- Current evidence indicates differential effects of antihypertensive drug classes on carbohydrate metabolism and diabetes risk.
- Further research is needed to fully elucidate the metabolic properties of newer antihypertensive agents and their implications for cardiovascular risk.
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