Antihypertensive medications and blood sugar: theories and implications.
Increased rates of diabetes have been reported with thiazide diuretics and beta-blockers, but not with angiotensin-converting enzyme inhibitors, angiotensin receptor blockers or calcium channel blockers. These observations are important because significant glycemic effects of drugs may be a source of accelerated cardiovascular risk that is not detectable during restricted clinical trial follow-up periods. The extent to which diabetes is affected by these medications remains unclear, as is the precise mechanism by which diabetes is promoted. However, several plausible theories are presented herein. Although drug-induced diabetes has been a concern for several years, not enough information is available to influence prescribing for the majority of patients. The number one priority should be controlling blood pressure in a timely manner.
Blackburn
David F
DF
College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon. d.blackburn@usask.ca
Wilson
Thomas W
TW
D000319:Adrenergic beta-Antagonists / Q000008:administration & dosage / Q000009:adverse effects*; D000959:Antihypertensive Agents / Q000008:administration & dosage / Q000009:adverse effects*; D001786:Blood Glucose / Q000187:drug effects* / Q000378:metabolism; D003920:Diabetes Mellitus / Q000139:chemically induced* / Q000453:epidemiology; D004359:Drug Therapy, Combination; D006801:Humans; D006973:Hypertension / Q000188:drug therapy; D015994:Incidence; D049993:Sodium Chloride Symporter Inhibitors / Q000008:administration & dosage / Q000009:adverse effects*
D000319:Adrenergic beta-Antagonists; D000959:Antihypertensive Agents; D001786:Blood Glucose; D049993:Sodium Chloride Symporter Inhibitors