New-onset diabetes and antihypertensive drugs

Giuseppe Mancia, Guido Grassi, Alberto Zanchetti

Research output: Contribution to journalArticlepeer-review


Observational studies have provided evidence that a consistent fraction (approximately 15-20%) of hypertensive patients displays a glucose intolerance state that may be aggravated by antihypertensive drug regimens based on thiazide diuretics or beta-blockers. This review examines the relative and absolute diabetogenic effects of antihypertensive drugs, by comparing the impact of 'new' (calcium antagonists, angiotensin-converting enzyme inhibitors and angiotensin II receptor antagonists) versus 'old' (diuretics and beta-blockers) drugs on new-onset diabetes in recent clinical trials. Evidence is provided that compared with diuretics and beta-blockers, new-onset diabetes is less common with 'new' drugs, and that conventional antihypertensive compounds, particularly when combined together, may amplify the natural time-dependent tendency towards the development of this metabolic disease. This paper provides new insights into the potential mechanisms responsible for the phenomenon and the clinical significance of antihypertensive drug-induced diabetes.

Original languageEnglish
Pages (from-to)3-10
Number of pages8
JournalJournal of Hypertension
Issue number1
Publication statusPublished - Jan 2006


  • Angiotensin inhibitors
  • Angiotensin-converting enzyme inhibitors
  • Beta-blockers
  • Calcium antagonists
  • Clinical trials
  • Diabetes
  • Diuretics

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology


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