Key result
In a network meta-analysis of 224,832 hypertensive patients, ARBs and ACE inhibitors were associated with a lower risk of new-onset diabetes compared to placebo, CCBs, and beta-blockers.
Why the study?
Do specific antihypertensive medication classes reduce the risk of new-onset diabetes mellitus in hypertensive patients?
Meta-Analysis (n=224,832)
Do specific antihypertensive medication classes reduce the risk of new-onset diabetes mellitus in hypertensive patients?
ARBs and ACEIs, particularly candesartan and enalapril, are the preferred antihypertensive agents for preventing new-onset diabetes in patients with hypertension.
Supports preferring ARBs or ACE inhibitors in hypertension to lower diabetes risk; extends comparative evidence from prior trials.
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.
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Yang et al. (2017) conducted a meta-analysis in Hypertension (n=224,832). Antihypertensive medication classes (ARBs, ACEIs, CCBs, beta-blockers, diuretics) vs. Placebo or other antihypertensive classes was evaluated on New-onset diabetes mellitus (NOD). In a network meta-analysis of 224,832 hypertensive patients, ARBs and ACE inhibitors were associated with a lower risk of new-onset diabetes compared to placebo, CCBs, and beta-blockers.
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