Antihypertensive Drugs Examined for Effects on Type 2 Diagnosis

A six-year study which appeared in the March 30 issue of The New England Journal of Medicine seeks to shed some light on which antihypertension drugs might induce type 2 diabetes.

Of the 12,550 test subjects, all of them between the ages of 45 and 64, a total of 1,146 had developed type 2 diabetes by the end of the study. Patients with hypertension were 2 1/2 times as likely to develop diabetes as those with normal blood pressure, confirming what earlier studies have demonstrated.

Subjects taking beta-blockers, however, were 28 percent more likely to incur type 2 diabetes than patients with hypertension not taking any medication. Subjects taking angiotensin-converting-enzyme (ACE) inhibitors, calcium-channel antagonists or thiazide diuretics did not raise their relative risk of developing diabetes. Previous studies had shown thiazide diuretics’ effects on relative diabetes risk to be suspect, but results had been inconclusive.

The study’s authors are cautious about sounding too loud an alarm over beta-blockers’ negative effects. They suggest that beta-blockers’ benefits in reducing the risk of cardiovascular events may outweigh the increased risks of developing type 2 diabetes. In an interview with Reuters Health, researcher Frederick Brancati also noted that the affordability of beta-blockers makes them an important medication for treating people with limited finances.

An editorial survey accompanying the study suggests that a combination of ACE inhibitors and beta-blockers might provide just the right formula to avoid any adverse effects. As these options are investigated, The NEJM editorial maintains beta-blockers should continue to be used to reduce the risk of coronary disease in patients with hypertension, diabetic or otherwise.

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