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Beta-Blockers for Hypertension: Risk Factor for Diabetes?

KEY POINT

You may see more ACE inhibitor therapy for hypertension as a result of recent findings. The possibility that beta-blockers can increase hypertensive patients’ risk for developing diabetes has some clinicians shying away from these traditional agents. Ramipril (Altace—Aventis Pharmaceuticals) prevented diabetes in patients who had vascular disease and lessened the progression of nephropathy in those who already had diabetes (see January issue of ADIL). This benefit is likely a class effect, meaning that all ACE inhibitors should provide similar protection.

SOURCES

Gress TW et al. Hypertension and antihypertensive therapy as risk factors for type 2 diabetes mellitus. N Engl J Med. 2000;342:905–12.

Sowers JR, Bakris GL. Antihypertensive therapy and the risk of type 2 diabetes mellitus [editorial]. N Engl J Med. 2000;342:969–70.

Capes SE et al. Enalapril prevents clinical proteinuria in diabetic patients with low ejection fraction. Diabetes Care. 2000;23:377–80.