Does blockade of the renin-angiotensin system by ACE inhibitors or ARBs prevent new onset of diabetes in patients with hypertension?
RAS blockade with ACE inhibitors or ARBs may inhibit the new onset of diabetes, highlighting a potential metabolic benefit in the management of hypertension.
Diabetes, which is frequently associated with hypertension, accelerates the development of hypertension-induced cardiovascular disease. Thus, the prevention of diabetes is important in the management of hypertension. Recent clinical megastudies have suggested that the blockade of the renin-angiotensin system (RAS) by angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARBs) inhibits new onset of diabetes. Thus, the agents to inhibit the RAS should be beneficial for glucose metabolism. However, the cardiovascular protective effects of ACE inhibitors and ARBs are not always superior to other classes of drugs. Further long-term clinical trials are necessary to clarify the anti-diabetic effect of the RAS-inhibiting agents.
Ando et al. (2005) studied this question.