The Glycemic Effects of Antihypertensive Medications

  • Joshua I. Barzilay
  • Barry R. Davis
  • Paul K. Whelton
Antihypertensive Agents: Mechanisms of Drug Action (M Ernst, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Antihypertensive Agents: Mechanisms of Drug Action

Abstract

Older antihypertensive medications are believed to be associated with metabolic disturbances, especially raised glucose levels. Owing to this, many physicians shun their use. Newer antihypertensive medications are metabolically neutral or metabolically favorable; therefore, they are looked upon favorably and are chosen as primary medications for the treatment of hypertension. Here we review the literature on the glucose effects of older and newer antihypertensive medications. We also consider what, if any, impact these metabolic effects have on cardiovascular disease outcomes. We show that the diabetogenic effects of thiazide diuretics and beta blockers are small relative to the glucose effects of angiotensin-converting enzyme inhibitors (ACEIs) and calcium channel blockers, and that over time, the glucose differences between older and newer medications diminish. Importantly, we show that the diabetogenic effects of older antihypertensive medications do not translate into increased cardiovascular disease risk.

Keywords

Diabetes Hypertension Risk Chlorthalidone Lisinopril Amlodipine Beta blocker ALLHAT Cardiovascular disease Side effect 

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Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Joshua I. Barzilay
    • 1
    • 2
  • Barry R. Davis
    • 3
  • Paul K. Whelton
    • 4
  1. 1.Kaiser Permanente of GeorgiaAtlantaUSA
  2. 2.Division of EndocrinologyEmory University School of MedicineAtlantaUSA
  3. 3.Division of Biostatistics, School of Public HealthUniversity of Texas Medical CenterHoustonUSA
  4. 4.School of Public Health and Tropical MedicineTulane UniversityNew OrleansUSA

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