Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Study Finds Differences between Blood Pressure Medicines and Newly-Diagnosed Diabetes

23.01.2007
Rush Researchers Identify Antihypertensive Drugs That Facilitate and/or Prevent Diabetes

Patients with high blood pressure are more likely to develop new-onset diabetes than those who don’t have hypertension, but this tendency is often attributed to higher weight, recent weight gain, or stronger family history of diabetes among those with high blood pressure Doctors have known since 1958 that some drugs used to control high blood pressure have the side effect of increasing blood sugar and causing new-onset diabetes.

Researchers at Rush University Medical Center analyzed the data from all of the randomized clinical trials (in which the assignment of initial drugs is based solely on chance, thus balancing the groups regarding other risk factors for diabetes), and have found significant differences between antihypertensive drugs. ACE-inhibitors and the newer angiotensin receptor blockers, or ARBs prevent people from getting diabetes, and the older diuretics or beta-blockers, increase the chance that a person becomes diabetic, compared to either placebo (inactive sugar-pills) or calcium channel blockers according to a study published in the January 20, 2007 issue of The Lancet.

Rush Preventive Medicine professor Dr. William J. Elliott, and Peter Meyer, Ph.D., director of the Section of Biostatistics, analyzed 22 long-term randomized clinical trials of each class of antihypertensive drugs, including placebo (inactive sugar-pills), to assess the chance that a person would develop diabetes during about 5 years of observation. The studies included 143,153 patients, and took place from 1966 through mid-September of 2006.

Their novel method of combining all the information available from clinical trials found that the lowest risk of new-onset diabetes occurred with ARBs or ACE-inhibitors, followed by calcium channel blockers or placebo (both of which were relatively neutral), and highest with beta-blockers or diuretics. They concluded that compared to inactive sugar-pills, diuretics or beta-blockers slightly increase the risk of becoming diabetic, whereas ARBs or ACE-inhibitors significantly decrease the risk.

“Most other studies of the association between drugs used mostly for high blood pressure could have been confused by differences in the patients studied. By only including studies that used randomization to minimize and balance differences between those assigned to different antihypertensive drugs, and by using a novel technique that can attribute risk both between agents that have been directly compared, and those that compare the results indirectly, we can see differences that other techniques cannot,” said Elliott.

“Our ‘indirect comparisons’ are similar to the way oddsmakers in Las Vegas compute the point spread for Sunday’s Bears-Saints playoff game. Since the Bears and Saints haven’t played each other (i.e., a direct comparison) this season, one can compare the record of the Bears against those teams that the Saints have also played this season. We use a similar strategy to compare, for example, ACE-inhibitors vs. ARBs, which have not been compared directly in any clinical trial to date.”

The study is expected to be of greater interest in the United Kingdom than the United States, because the British National Institute of Health and Clinical Excellence issued a new set of guidelines about hypertension treatment for primary care physicians in June 2006 that are based on economic considerations. Because diabetics generate about 4 times the healthcare expenditures as non-diabetics, the new British guidelines recommend against using both a diuretic and a beta-blocker for the routine treatment of hypertension. In the United States, however, tradition and the 2003 national hypertension guidelines still recommend a diuretic as first-line treatment, and a beta-blocker only one of several acceptable second-line options.

The authors were careful to point out that their data do not address the ongoing controversy about whether new-onset diabetes leads to as many heart attacks, strokes or death, as long-standing diabetes, which will require more studies.

The authors’ data do suggest, however, that the differences between antihypertensive drugs regarding the risk for new-onset diabetes are real and significant. Whether an overweight person with hypertension, others in the family with diabetes, and a recent weight gain can avoid the diagnosis of diabetes in the long-term by taking a specific type of antihypertensive drug is uncertain, and should be discussed with the treating physician as just one aspect of the choice of drug to lower blood pressure in that individual.

Kim Waterman | EurekAlert!
Further information:
http://www.rush.edu

More articles from Health and Medicine:

nachricht New malaria analysis method reveals disease severity in minutes
14.08.2017 | University of British Columbia

nachricht New type of blood cells work as indicators of autoimmunity
14.08.2017 | Instituto de Medicina Molecular

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Fizzy soda water could be key to clean manufacture of flat wonder material: Graphene

Whether you call it effervescent, fizzy, or sparkling, carbonated water is making a comeback as a beverage. Aside from quenching thirst, researchers at the University of Illinois at Urbana-Champaign have discovered a new use for these "bubbly" concoctions that will have major impact on the manufacturer of the world's thinnest, flattest, and one most useful materials -- graphene.

As graphene's popularity grows as an advanced "wonder" material, the speed and quality at which it can be manufactured will be paramount. With that in mind,...

Im Focus: Exotic quantum states made from light: Physicists create optical “wells” for a super-photon

Physicists at the University of Bonn have managed to create optical hollows and more complex patterns into which the light of a Bose-Einstein condensate flows. The creation of such highly low-loss structures for light is a prerequisite for complex light circuits, such as for quantum information processing for a new generation of computers. The researchers are now presenting their results in the journal Nature Photonics.

Light particles (photons) occur as tiny, indivisible portions. Many thousands of these light portions can be merged to form a single super-photon if they are...

Im Focus: Circular RNA linked to brain function

For the first time, scientists have shown that circular RNA is linked to brain function. When a RNA molecule called Cdr1as was deleted from the genome of mice, the animals had problems filtering out unnecessary information – like patients suffering from neuropsychiatric disorders.

While hundreds of circular RNAs (circRNAs) are abundant in mammalian brains, one big question has remained unanswered: What are they actually good for? In the...

Im Focus: RAVAN CubeSat measures Earth's outgoing energy

An experimental small satellite has successfully collected and delivered data on a key measurement for predicting changes in Earth's climate.

The Radiometer Assessment using Vertically Aligned Nanotubes (RAVAN) CubeSat was launched into low-Earth orbit on Nov. 11, 2016, in order to test new...

Im Focus: Scientists shine new light on the “other high temperature superconductor”

A study led by scientists of the Max Planck Institute for the Structure and Dynamics of Matter (MPSD) at the Center for Free-Electron Laser Science in Hamburg presents evidence of the coexistence of superconductivity and “charge-density-waves” in compounds of the poorly-studied family of bismuthates. This observation opens up new perspectives for a deeper understanding of the phenomenon of high-temperature superconductivity, a topic which is at the core of condensed matter research since more than 30 years. The paper by Nicoletti et al has been published in the PNAS.

Since the beginning of the 20th century, superconductivity had been observed in some metals at temperatures only a few degrees above the absolute zero (minus...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

Call for Papers – ICNFT 2018, 5th International Conference on New Forming Technology

16.08.2017 | Event News

Sustainability is the business model of tomorrow

04.08.2017 | Event News

Clash of Realities 2017: Registration now open. International Conference at TH Köln

26.07.2017 | Event News

 
Latest News

A Map of the Cell’s Power Station

18.08.2017 | Life Sciences

Engineering team images tiny quasicrystals as they form

18.08.2017 | Physics and Astronomy

Researchers printed graphene-like materials with inkjet

18.08.2017 | Materials Sciences

VideoLinks
B2B-VideoLinks
More VideoLinks >>>