New Onset of Type 2 Diabetes Mellitus during Antihypertensive Therapy

摘要: Hypertension is a widely diffused clinical condition in the general population and it often associated with people who are overweight (i.e. have abdominal adiposity) or obese metabolic syndrome. Evidence shows that hypertensive patients at increased risk of developing type 2 diabetes mellitus (T2DM) since angiotensin II involved pathogenesis hypertension insulin resistance, which both key components The preventive effect renin-angiotensin system (RAS) inhibition on development T2DM could reflect closely linked mechanisms blood pressure glucose homeostasis. Since hyperglycaemia consequence resistance β-cell dysfunction, preventing by RAS may result from an improvement function and/or enhancement sensitivity, secondary to modifications microcirculation changes ionic status. On basis this hypothesis, several trials treating shown positive drugs inhibiting reducing number develop T2DM. We analysed results following studies found reduction incidence new-onset using 1 receptor blockers (ARBs): LIFE (Losartan Intervention For Endpoint hypertension) [losartan]; SCOPE (Study COgnition Prognosis Elderly) [candesartan]; ALPINE (Antihypertensive treatment Lipid Profile In North Sweden Efficacy evaluation) CHARM (Candesartan Heart failure Assessment Reduction Mortality morbidity) VALUE (Valsartan Antihypertensive Long-term Use Evaluation) [valsartan]. reduction, when lifestyle (especially high-risk patients), more important than mechanism action antihypertensive drugs, normalise thus reduce cardiovascular events. regard, identification potential influence subjects promising topic for healthcare system. future, data ongoing trials, where prevention primary endpoint, prove what extent class actually effective. However, previously mentioned superior effectiveness ARBs lower efficacy events, because their lesser capacity lowering pressure. so far suggests use preferably association other classes under constant control latter recently published ASCOT-BPLA (Anglo-Scandinavian Cardiac Outcomes Trial—Blood Pressure Lowering Arm) study, combination therapy based drug (perindopril) calcium-channel blocker (amlodipine) significantly reduced major events new onset patients, compared thiazide diuretic β-blocker.