André J Scheen1,2. 1. Division of Diabetes, Nutrition and Metabolic Disorders, Department of Medicine, CHU Liège, University of Liège, CHU Sart Tilman (B35), B-4000, Liege, Belgium. andre.scheen@chu.ulg.ac.be. 2. Clinical Pharmacology Unit, CHU Liège, Center for Interdisciplinary Research on Medicines (CIRM), University of Liège, Liège, Belgium. andre.scheen@chu.ulg.ac.be.
Abstract
PURPOSE OF REVIEW: In patients with prediabetes or type 2 diabetes, the use of thiazides as antihypertensive agents has been challenged because associated metabolic adverse events, including new-onset diabetes. RECENT FINDINGS: These metabolic disturbances are less marked with low-dose thiazides and, in most but not all studies, with thiazide-like diuretics (chlorthalidone, indapamide) than with thiazide-type diuretics (hydrochlorothiazide). In post hoc analyses of subgroups of patients with hypertension and type 2 diabetes, thiazides resulted in a significant reduction in cardiovascular events, all-cause mortality, and hospitalization for heart failure compared to placebo and generally were shown to be non-inferior to other antihypertensive agents. Benefits attributed to thiazide diuretics in terms of cardiovascular event reduction outweigh the risk of worsening glucose control in type 2 diabetes and of new-onset diabetes in non-diabetic patients. Thiazides still play a key role in the management of patients with type 2 diabetes and hypertension.
PURPOSE OF REVIEW: In patients with prediabetes or type 2 diabetes, the use of thiazides as antihypertensive agents has been challenged because associated metabolic adverse events, including new-onset diabetes. RECENT FINDINGS: These metabolic disturbances are less marked with low-dose thiazides and, in most but not all studies, with thiazide-like diuretics (chlorthalidone, indapamide) than with thiazide-type diuretics (hydrochlorothiazide). In post hoc analyses of subgroups of patients with hypertension and type 2 diabetes, thiazides resulted in a significant reduction in cardiovascular events, all-cause mortality, and hospitalization for heart failure compared to placebo and generally were shown to be non-inferior to other antihypertensive agents. Benefits attributed to thiazide diuretics in terms of cardiovascular event reduction outweigh the risk of worsening glucose control in type 2 diabetes and of new-onset diabetes in non-diabeticpatients. Thiazides still play a key role in the management of patients with type 2 diabetes and hypertension.
Authors: Dragos Vinereanu; Raluca Dulgheru; Stefania Magda; Ruxandra Dragoi Galrinho; Maria Florescu; Mircea Cinteza; Christopher Granger; Andrea O Ciobanu Journal: Am Heart J Date: 2014-06-13 Impact factor: 4.749
Authors: Morris J Brown; Bryan Williams; Steve V Morant; David J Webb; Mark J Caulfield; J Kennedy Cruickshank; Ian Ford; Gordon McInnes; Peter Sever; Jackie Salsbury; Isla S Mackenzie; Sandosh Padmanabhan; Thomas M MacDonald Journal: Lancet Diabetes Endocrinol Date: 2015-10-18 Impact factor: 32.069
Authors: Henry Chijioke Onyegbutulem; Dilli Dogo; Francis Alu; Musa Dankyau; David Samuel Olorunfemi; Faruk Mustapha Abdullahi; Isaac Olubanji Akerele; Nafisah Ja'afar Bala; Ugo Nnenna Ibeabuchi; Maimuna Onyi Mohammed Journal: Pan Afr Med J Date: 2021-05-04
Authors: Giulio Di Mizio; Gianmarco Marcianò; Caterina Palleria; Lucia Muraca; Vincenzo Rania; Roberta Roberti; Giuseppe Spaziano; Amalia Piscopo; Valeria Ciconte; Nunzio Di Nunno; Massimiliano Esposito; Pasquale Viola; Davide Pisani; Giovambattista De Sarro; Milena Raffi; Alessandro Piras; Giuseppe Chiarella; Luca Gallelli Journal: Int J Environ Res Public Health Date: 2021-12-08 Impact factor: 3.390