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The Glycemic Effects of Antihypertensive Medications

  • Antihypertensive Agents: Mechanisms of Drug Action (M Ernst, Section Editor)
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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.

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Conflict of Interest

Joshua I. Barzilay and Paul K. Whelton declare that they have no conflict of interest.

Barry R. Davis has received a grant from the National Institutes of Health and has been a consultant for Merck & Co., Inc., as a DSMB member.

None of the authors has a conflict of interest regarding the contents of this study.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

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Authors and Affiliations

  1. Kaiser Permanente of Georgia, 3650 Steve Reynolds Blvd, Atlanta, GA, 30096, USA

    Joshua I. Barzilay

  2. Division of Endocrinology, Emory University School of Medicine, Atlanta, GA, USA

    Joshua I. Barzilay

  3. Division of Biostatistics, School of Public Health, University of Texas Medical Center, Houston, TX, USA

    Barry R. Davis

  4. School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA

    Paul K. Whelton

Authors
  1. Joshua I. Barzilay
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  2. Barry R. Davis
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  3. Paul K. Whelton
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Correspondence to Joshua I. Barzilay.

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This article is part of the Topical Collection on Antihypertensive Agents: Mechanisms of Drug Action

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Barzilay, J.I., Davis, B.R. & Whelton, P.K. The Glycemic Effects of Antihypertensive Medications. Curr Hypertens Rep 16, 410 (2014). https://doi.org/10.1007/s11906-013-0410-z

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  • DOI: https://doi.org/10.1007/s11906-013-0410-z

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