Effect of Antihypertensive Agents on the Development of Type 2 Diabetes Mellitus

Stump, Craig S.; Hamilton, Marc T.; Sowers, James R.
June 2006
Mayo Clinic Proceedings;Jun2006, Vol. 81 Issue 6, p796
Academic Journal
People with hypertension have a high prevalence of insulin resistance and are at relatively high risk of developing type 2 diabetes mellitus. It is becoming increasingly evident that antihypertensive agents have disparate metabolic effects. For example, recent clinical trials Indicate that agents that interrupt the renin-angiotensin axis reduce the risk of developing diabetes compared with other classes of antihypertensive agents. Blockade of the effects of angiotensin II might improve blood flow to insulin-sensitive tissues. Furthermore, interruption of the renin-angiotensin system might provide metabolic benefit through such mechanisms as reduced oxidative stress and restored nitric oxide production, which could lead to improved insulin signaling. Alternatively, collective trials suggest that both diuretics and 13-blockers accelerate the appearance of new-onset type 2 diabetes mellitus in patients with hypertension. Therefore, the risk of new-onset diabetes-associated cardiovascular risks should be factored into future treatment recommendations for patients who require antihypertensive therapy. This will become even more important as the number of insulin-resistant patients with hypertension increases in parallel with the steady growth in the number of sedentary, obese, and aged persons in our population.


Related Articles

  • Efficacy of newer versus older antihypertensive drugs in black patients living in sub-Saharan Africa. M'Buyamba-Kabangu, J R; Anisiuba, B C; Ndiaye, M B; Lemogoum, D; Jacobs, L; Ijoma, C K; Thijs, L; Boombhi, H J; Kaptue, J; Kolo, P M; Mipinda, J B; Osakwe, C E; Odili, A; Ezeala-Adikaibe, B; Kingue, S; Omotoso, B A; Ba, S A; Ulasi, I I; Staessen, J A // Journal of Human Hypertension;Dec2013, Vol. 27 Issue 12, p729 

    To address the epidemic of hypertension in blacks born and living in sub-Saharan Africa, we compared in a randomised clinical trial (NCT01030458) single-pill combinations of old and new antihypertensive drugs in patients (30-69 years) with uncomplicated hypertension (140-179/90-109 mm Hg). After...

  • Tuberculosis: clinical management and medicolegal pitfalls. Branley, Howard M. // Clinical Risk;Nov2009, Vol. 15 Issue 6, p247 

    This paper describes the diagnosis and treatment of the various forms of tuberculosis covering drug resistance and at-risk groups. The second part of the paper considers the medicolegal aspects of failure to diagnose and treat with appropriate therapy.

  • The Effect of Antihypertensive Drugs on Endothelial Function as Assessed by Flow-Mediated Vasodilation in Hypertensive Patients. Michiaki Miyamoto; Kazuhiko Kotani; Shun Ishibashi; Nobuyuki Taniguchi // International Journal of Vascular Medicine;2012, p1 

    Endothelial dysfunction is found in hypertensive patients and may serve as a prognostic marker of future cardiovascular events. Endothelial function can be assessed noninvasively by flow-mediated vasodilation (FMD). The goal of this paper is to summarize comprehensively the clinical trials that...

  • The HYPERFlax trial for determining the anti-HYPERtensive effects of dietary flaxseed in newly diagnosed stage 1 hypertensive patients: study protocol for a randomized, double-blinded, controlled clinical trial. Caligiuri, Stephanie P. B.; Penner, Brian; Pierce, Grant N. // Trials;2014, Vol. 15 Issue 1, p1 

    Background In 2013 the World Health Organization deemed hypertension as a global crisis as it is the leading risk factor attributed to global mortality. Therefore, there is a great need for effective alternative treatment strategies to combat a condition that affects 40% of adults worldwide....

  • Antihypertensive Efficacy of the Direct Renin Inhibitor Aliskiren in Patients With Diabetes: A Pooled Analysis of 10 Randomized Trials. Taylor, Addison A.; Anderson, David R.; Arora, Vipin; Bush, Christopher; Keefe, Deborah L. // Diabetes;Jun2007 Supplement 1, Vol. 56, pA129 

    Patients (pts) with diabetes (DM) and hypertension have a high risk of cardiovascular events, but. blood pressure (BP) control is hard to achieve in this group. We report here a pooled analysis of effects of monotherapy with the direct renin inhibitor aliskiren on mean sitting systolic/diastolic...

  • Effects of antihypertensive treatment in patients over 65 years of age: a meta-analysis of randomised controlled studies. Briasoulis, Alexandros; Agarwal, Vikram; Tousoulis, Dimitris; Stefanadis, Christodoulos // Heart;Feb2014, Vol. 100 Issue 4, p317 

    Context Despite the high incidence of hypertension, the elderly population is not represented in clinical trials as they have upper age limits or do not present agespecific results. Objectives The present study was designed to systematically review prospective randomized trials and assess the...

  • Comparative effects of atenolol-based and amlodipine-based antihypertensive therapy on QT dispersion in hypertensive subjects. Oikarinen, L; Viitasalo, M; Toivonen, L; Nieminen, M S // Journal of Human Hypertension;Aug2001 Supplement, Vol. 15 Issue 8, pS43 

    Discusses effects of atenolol-based and amlodipine-based antihypertensive drugs on QT dispersion in hypertensive patients. Reasons provided for therapeutic use of the drugs for hypertensive patients; Observation of QT interval durations in different electrocardiograms; Association of left...

  • Patients persist with antihypertensives in Norway.  // PharmacoEconomics & Outcomes News;4/14/2012, Issue 651, p9 

    The article discusses research on the persistence rates with antihypertensive therapy of hypertensive patients in Norway, referencing a study by R. Selmer and colleagues published on the March 18, 2012 issue of the "European Journal of Clinical Pharmacology."

  • Olmesartan Medoxomil. Grassi, Guido; Mancia, Giuseppe // High Blood Pressure & Cardiovascular Prevention;Mar2010, Vol. 17 Issue 1, p1 

    Inadequate blood pressure (BP) control represents one of the major challenges of antihypertensive treatment, being responsible for the elevated cardiovascular morbidity and mortality associated with hypertension. Although guidelines strongly recommend BP control as a primary therapeutic goal,...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics