title: Comparing six antihypertensive medication classes for preventing new-onset diabetes mellitus among hypertensive patients: a network meta-analysis.
abstract: Hypertensive patients usually have a higher risk of new-onset diabetes mellitus (NOD) which may trigger cardiovascular diseases. In this study, the effectiveness of six antihypertensive agents with respect to NOD prevention in hypertensive patients was assessed. A network meta-analysis was conducted to compare the efficacy of specific drug classes. PubMed and Embase databases were searched for relevant articles. Results of the pairwised meta-analysis were illustrated by odd ratios (OR) and a corresponding 95% confidence interval (CI). The probabilities and outcome of each treatment were ranked and summarized using the surface under the cumulative ranking curve (SUCRA).Twenty-three trials were identified, including 224,832 patients with an average follow-up period of 3.9 ± 1.0 years. The network meta-analysis showed that patients treated by angiotensin II receptor blockers (ARBs) were associated with a lower risk of NOD compared to placebo (PCB), calcium channel blockers (CCBs) and β-blockers, while diuretic appeared to be ineffective for NOD prevention. Network meta-analysis results of specific drugs showed that enalapril exhibited distinct advantages and hydrochlorothiazide also exhibited a reliable performance. Our results suggested that both ARBs and angiotensin converse enzyme inhibitors (ACEIs), especially candesartan and enalapril, were preferable for NOD prevention in hypertensive patients. Hydrochlorothiazide also exhibited a reliable performance in comparison with other agents.
authors.affiliation: Department of Social Medicine, School of Public Health, Central South University, Changsha, Hunan, China.
authors.forename: Yang
authors.initials: Y
authors.lastname: Yang
authors.affiliation: Department of Social Medicine, School of Public Health, Central South University, Changsha, Hunan, China.
authors.forename: Huilan
authors.initials: H
authors.lastname: Xu
mesh_terms: D000959:Antihypertensive Agents / Q000627:therapeutic use*; D003920:Diabetes Mellitus / Q000453:epidemiology / Q000517:prevention & control*; D006801:Humans; D015994:Incidence; D011336:Probability
chemical_list: D000959:Antihypertensive Agents
keywords: angiotensin II converse enzyme inhibitors; angiotensin II receptor blockers; calcium channel blockers; diuretic; hypertension; new-onset diabetes; β-blockers