NEW – ONSET DIABETES AND HYPERTENSION

                                   COULD IT BE CAUSED BY BLOOD PRESSURE MEDICATIONS?

In clinical practice of medicine, when we detect a new onset of diabetes, during the course of high blood pressure treatments, we doctors often ask the above question to ourself.

We also try not to prescribe diuretics and beta – blocker medications to hypertensive diabetics and to those who have substantial risks to develop diabetes in the future, like obese patients and patients with positive family history of diabetes, solely based on anecdotal evidence.

In a recent article published in prestigious, international medical journal Lancet (2021, Now 13;398:1807), researchers conducted an individual patient level based meta-analysis of 22 large, randomized trials for cardiovascular prevention, as well as to find answer to the above-mentioned question. In this study a specific, a class of antihypertensive drug was compared to placebo or another class of hypertensive drug. Overall evaluation with 4,5 years of follow-up showed that lowering BP even 5 mm Hg significantly lowered the risk for type2 diabetes. 

Among antihypertensive drug classes ACE (Angiotensin Converting Enzymes) inhibitors, and ARBs (Angiotensin Receptors Blockers) have significantly lowered diabetes risk. On the other hand, Thiazide diuretics and beta – blockers significantly raised the risk of diabetes, but calcium channel blocker medication class had no effects.

In conclusion, it appears that clinicians should consider either ACE inhibitors or even better ARB (for having less side effects) as the first line of treatments for hypertension.