Cardiovascular therapies and associated glucose homeostasis: implications across the dysglycemia continuum.
Certain cardiovascular drugs have adverse effects on glucose homeostasis, which may lead to important long-term implications for increased risks of adverse outcomes. Thiazide diuretics, niacin, and beta-adrenergic blockers impair glucose homeostasis. However, angiotensin-converting enzyme inhibitors and angiotensin receptor blockers have demonstrated beneficial metabolic effects. The newer vasodilating beta-blocking agents and calcium antagonists appear to be metabolically neutral. These considerations, in addition to meticulous attention to blood pressure control and lifestyle changes, have the potential to beneficially modify glycemia and long-term risks. These considerations have particular importance in younger patients who may also have pre-diabetes or the metabolic syndrome and who are likely to require therapy over the course of decades.
Cooper-DeHoff
Rhonda M
RM
Division of Cardiovascular Medicine, College of Medicine, University of Florida, Gainesville, Florida 32610-0277, USA. dehofrm@medicine.ufl.edu
Pacanowski
Michael A
MA
Pepine
Carl J
CJ
D000319:Adrenergic beta-Antagonists / Q000009:adverse effects; D057911:Angiotensin Receptor Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000494:pharmacology; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001786:Blood Glucose / Q000187:drug effects*; D002317:Cardiovascular Agents / Q000008:administration & dosage / Q000009:adverse effects*; D003324:Coronary Artery Disease / Q000097:blood / Q000209:etiology* / Q000503:physiopathology; D018149:Glucose Intolerance / Q000097:blood / Q000517:prevention & control; D006706:Homeostasis; D006801:Humans; D006943:Hyperglycemia / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007328:Insulin / Q000627:therapeutic use*; D024821:Metabolic Syndrome / Q000097:blood / Q000150:complications; D009525:Niacin / Q000009:adverse effects; D040242:Risk Reduction Behavior; D049993:Sodium Chloride Symporter Inhibitors / Q000009:adverse effects
D000319:Adrenergic beta-Antagonists; D057911:Angiotensin Receptor Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D000959:Antihypertensive Agents; D001786:Blood Glucose; D002317:Cardiovascular Agents; D007004:Hypoglycemic Agents; D007328:Insulin; D049993:Sodium Chloride Symporter Inhibitors; D009525:Niacin