Key result
Genetically proxied ACE inhibition was associated with a lower risk of diabetes (OR 0.85), whereas genetic proxies for beta-blockers were associated with a higher risk of diabetes (OR 1.05).
Why the study?
Pleiotropic effects of different antihypertensive drug classes on CVD risk factors, such as diabetes and lipids, have not been assessed in long-term, large randomised controlled trials, particularly in East Asians.
Do genetically proxied ACE inhibitors, beta-blockers, and calcium channel blockers affect the risk of diabetes and metabolic traits in European and East Asian populations?
Population
European and East Asian individuals from genome-wide association studies
Comparison
Genetically proxied ACE inhibitors vs beta-blockers vs calcium channel blockers
Design
Trans-ancestry Mendelian randomisation study
Authors
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I need the paper’s actual verdict and endpoints before writing the implication. Searching now.Pulling the paper’s conclusions and discussion so the implication matches the primary verdict.May inform class choice when metabolic risk is high; extends RCT metabolic signals to East Asians and leaves practice change open.
Observational (n=1,331,670)
Do genetically proxied ACE inhibitors, beta-blockers, and calcium channel blockers affect the risk of diabetes and metabolic traits in European and East Asian populations?
Odds Ratio: 0.85 (95% CI 0.78–0.93)
p-value: p=2.8x10-4
Mendelian randomization suggests ACE inhibitors may protect against diabetes, while beta-blockers and calcium channel blockers may have unfavorable metabolic effects, supporting tailored antihypertensive therapy.
Zhao et al. (2022) conducted an observational in Diabetes and hyperlipidaemia (n=1,331,670). Genetically proxied ACE inhibitors, beta-blockers, and calcium channel blockers vs. Unexposed (genetic reference) was evaluated on Risk of diabetes (Europeans) (OR 0.85, 95% CI 0.78-0.93, p=2.8x10-4). Genetically proxied ACE inhibition was associated with a lower risk of diabetes (OR 0.85), whereas genetic proxies for beta-blockers were associated with a higher risk of diabetes (OR 1.05).
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