CORRELATION OF ANTIHYPERTENSIVE DRUGS AND NEW ONSET DIABETES: A REVIEW

Abstract

Hypertension is the leading cause of mortality worldwide and is a leading risk factor for the development of coronary heart disease and stroke. Diabetes and high blood pressure tend to occur together because they share certain physiological traits. Antihypertensive drugs are prescribed mainly to reduce the morbidity and mortality caused by hypertension and its complications. Clinical practice guidelines suggest antihypertensive classes are acceptable first-line agents for the management of uncomplicated hypertension. These classes include angiotensin receptor blockers, thiazide diuretics, angiotensin-converting enzyme inhibitors (ACE-I), calcium channel blockers, beta-blockers. It has been observed that type-2 diabetes has been promoted by not only hypertension but also by antihypertensive therapies. Several studies indicate and beta blockers and diuretics impair the glucose metabolism, hence not only the disease itself but also antihypertensive therapies may promote the development of new-onset diabetes. The s- blockers and diuretics have also the role in decreasing the morbidity and mortality by cardiovascular reasons, identified in clinical trials. It is also pertinent to add that the risk of new onset diabetes has been found increasing by thiazide diuretics and s- blockers. If these both classes are used in combination the effect is noticed stronger. The incidence of new onset diabetes in hypertensive patients might have reduced by ingestion of angiotensin receptor blockers (ARBs), or ACE inhibitors (ACEIs). This is reflected in the suggestions issued in the reviews of several clinical trials. It is also found that the co-existence of hypertension and diabetes mellitus is destructive to cardiovascular system, which may consequently lead the risk of stroke or even cardiovascular mortality, hence caution should be taken while prescribing antihypertensive medications.