Effect of antihypertensive agents on the development of type 2 diabetes mellitus.

Abstract:

:People with hypertension have a high prevalence of insulin resistance and are at relatively high risk of developing type 2 diabetes mellitus. It is becoming increasingly evident that antihypertensive agents have disparate metabolic effects. For example, recent clinical trials indicate that agents that interrupt the renin-angiotensin axis reduce the risk of developing diabetes compared with other classes of antihypertensive agents. Blockade of the effects of angiotensin II might improve blood flow to insulin-sensitive tissues. Furthermore, interruption of the renin-angiotensin system might provide metabolic benefit through such mechanisms as reduced oxidative stress and restored nitric oxide production, which could lead to improved insulin signaling. Alternatively, collective trials suggest that both diuretics and beta-blockers accelerate the appearance of new-onset type 2 diabetes mellitus in patients with hypertension. Therefore, the risk of new-onset diabetes-associated cardiovascular risks should be factored into future treatment recommendations for patients who require antihypertensive therapy. This will become even more important as the number of insulin-resistant patients with hypertension increases in parallel with the steady growth in the number of sedentary, obese, and aged persons in our population.

journal_name

Mayo Clin Proc

journal_title

Mayo Clinic proceedings

authors

Stump CS,Hamilton MT,Sowers JR

doi

10.4065/81.6.796

subject

Has Abstract

pub_date

2006-06-01 00:00:00

pages

796-806

issue

6

eissn

0025-6196

issn

1942-5546

pii

S0025-6196(11)61734-5

journal_volume

81

pub_type

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