Key result
Current data are insufficient to suggest that the 1%-3.5% increased incidence of new-onset diabetes associated with certain antihypertensives significantly affects mortality or morbidity outcomes.
Why the study?
Is new-onset diabetes associated with antihypertensive therapy clinically significant regarding mortality or morbidity in treated hypertensive patients?
Is new-onset diabetes associated with antihypertensive therapy clinically significant regarding mortality or morbidity in treated hypertensive patients?
Current evidence is insufficient to suggest that new-onset diabetes induced by antihypertensive therapy significantly impacts mortality or morbidity, supporting the continued use of diuretics as recommended.
Insufficient evidence to alter prescribing over new diabetes risk; leaves open need for longer outcome trials.
There is little doubt that diabetes is more common in hypertensive than normotensive individuals. There are also some data suggesting that the use of certain antihypertensive agents, i.e., diuretics and more specifically some beta blockers will increase the occurrence of new onset diabetes (NOD) when compared to other medications, especially angiotensin-converting enzyme inhibitors or angiotensin receptor blockers. The clinical significance of this 1%-3.5% difference, however, has not been established. Different studies report different outcomes. In large outcome trials the occurrence of NOD did not effect mortality or morbidity outcomes. Although one study reported that NOD had the same prognosis as pretreatment diabetes, another did not. At present, data are insufficient to suggest that NOD is of important clinical significance or that present treatment recommendations, especially regarding the use of diuretics, should be changed.
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Marvin Moser (2006) conducted an editorial in Hypertension. Diuretics and beta blockers vs. Angiotensin-converting enzyme inhibitors or angiotensin receptor blockers was evaluated on New-onset diabetes and associated mortality or morbidity. Current data are insufficient to suggest that the 1%-3.5% increased incidence of new-onset diabetes associated with certain antihypertensives significantly affects mortality or morbidity outcomes.
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