Key result
Combination antihypertensive therapy linked to ~5.6-fold higher risk of new-onset diabetes versus monotherapy.
Why the study?
The association between antihypertensive drug use and new-onset diabetes in patients with hypertension remained to be determined.
Does the use of specific antihypertensive drugs increase the risk of new-onset diabetes in patients with hypertension?
Observational (n=952)
No
Does the use of specific antihypertensive drugs increase the risk of new-onset diabetes in patients with hypertension?
Odds Ratio: 5.6 (95% CI 3.77–8.3)
Certain antihypertensive medications, particularly combination therapies, ARBs, and diuretics, are associated with an increased risk of new-onset diabetes in hypertensive patients.
May warrant caution with combination antihypertensives; leaves open causality and requires randomized confirmation.
Objective: The objective of this study was to determine the association between antihypertensive drug use and new-onset diabetes (NOD) in patients with hypertension (HTN). Materials and Methods: A retrospective observational study was conducted in a tertiary care hospital located in south India. Patients diagnosed with HTN and HTN with diabetes between January 2012 and December 2016, were identified and studied. Medical records of these patients from Medical Record Department were evaluated by medical record review method, and relevant data were recorded in a case record form. Statistical evaluation by chi-square method and odds ratio (OR) was carried out to appraise the incidence of NOD in patients taking antihypertensive medications. Results: A total of 1250 patients with HTN were screened, and based on inclusion and exclusion criteria, 952 patients were enrolled in the study; among which, 537 were patients with HTN and 415 were patients with diabetic HTN. The majority of the patients with HTN and patients with diabetic HTN were from the age-group of above 60 years. The most commonly prescribed drugs observed in our study population were amlodipine in 94 (22.7%) patients. OR was calculated and it was observed that the combination therapy has a fivefold risk for the development of NOD in patients with HTN, followed by Angiotensin II receptor blockers (2.06) (confidence interval [CI]: 1.56–2.73), diuretics (1.33) (CI: 0.95–1.85), non-Dihydropyridine calcium channel blockers (DHP CCBs) (1.3) (CI: 0.51–3.30), vasodilators (1.13) (CI: 0.40–3.15), and Angiotensin converting enzyme inhibitors (1.06) (0.68–1.64). Conclusion: Patients on non-DHP CCBs, diuretics, and combination antihypertensives showed more chances of developing NOD.
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Seshadri et al. (2020) conducted an observational in Hypertension (n=952). Combination antihypertensive therapy vs. Antihypertensive monotherapy was evaluated on New-onset diabetes (OR 5.60, 95% CI 3.77-8.30). Combination antihypertensive therapy was associated with a more than fivefold increased risk of developing new-onset diabetes compared to monotherapy (OR 5.60).
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