In a long-term study of older adults with high blood pressure from the National Heart, Lung, and Blood Institute of the National Institutes of Health, participants without diabetes who were taking high blood pressure medications experienced increased average fasting glucose levels. This was true regardless of which class of medication was used: diuretic, ACE inhibitor, or calcium channel blocker. During a 4 year period, the glucose changes led to new diagnoses of diabetes in approximately 1 in 10 participants (diuretic 11.0 percent, ACE inhibitor 7.8 percent and calcium channel blocker 9.3 percent .) However, the results of this Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT) analysis showed no significant evidence that the new onset diabetes increased the risk of stroke, heart failure, or death from any cause, but it did increase the risk of heart attack. In those taking a diuretic, the relationship between new diabetes and coronary disease was actually less than in those taking the other drugs and not significant for the diuretic. According to the authors, this suggests that the glucose changes induced by diuretics do not lead to heart disease in the same way as diabetes caused by overweight, inactivity, and genetic predisposition. This finding is strongly supported by previous findings in a 14-year follow-up of the Systolic Hypertension in the Elderly Program (SHEP).
"Fasting Glucose and Incident Diabetes Mellitus in Older Non-diabetic Adults Randomized to Receive Three Different Classes of Antihypertensive Treatment," is published in the November 13, 2006 issue of Archives of Internal Medicine.
Jeffrey Cutler, M.D., co-author of the paper and project director of the ALLHAT study, is available to comment on the study's findings.
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