Long-term effects of antihypertensive drugs on the risk of new-onset diabetes in elderly Taiwanese hypertensives.

Antihypertensive drugs have been linked to new-onset diabetes (NOD); however, the effects of these drugs on the development of NOD in elderly Taiwanese hypertensive patients have not been well determined. We examined the association between antihypertensive drug therapy and the risk of NOD in a population-based study. The sample consisted of 8,638 elderly hypertensive patients. The data were obtained from claim forms provided to the central region branch of the Bureau of National Health Insurance in Taiwan from January 2001 to December 2006. Prescriptions for antihypertensive drugs before the index date were retrieved from a prescription database. We estimated the odds ratios (ORs) of NOD associated with antihypertensive drug use; nondiabetic subjects served as the reference group. The risk of NOD was higher among users of diuretics (OR, 1.12; 95% confidence interval [CI], 1.04-1.21), and beta-blockers (OR, 1.11; 95% CI, 1.02-1.20) than among nonusers. Patients who take angiotensin-converting enzyme (ACE) inhibitors (OR, 0.90; 95% CI, 0.82-0.98) or alpha-blockers (OR, 0.88; 95% CI, 0.78-0.99) are at a lower risk of developing NOD than nonusers. Angiotensin receptor blockers, calcium channel blockers, and vasodilators were not associated with risk of NOD. The results suggest that elderly hypertensive patients who take ACE inhibitors or alpha-blockers are at lower risk of NOD. Diuretics and beta-blockers were associated with a significant increase in the risk of NOD.