Metabolic Effects Of Antihypertensive Drugs

Arterial hypertension as a feature of the metabolic syndrome is often associated with pathologies of glucose metabolism. There are distinct differences between various classes of antihypertensive drugs with regard to their influence on glucose and lipid metabolisms that should be kept in mind when prescribing antihypertensive therapies.Diuretics, and especially betablockers of the older generation, have been shown in many prospective studies to cause significantly more new-onset diabetes mellitus type II than other antihypertensive drug classes. The causality can be found mainly in the deterioration of insulin sensitivity caused by these two groups.In contrast, the literature consistently depicts a reduction of new-onset diabetes under ACE-inhibitor or angiotension-receptor-1-antagonist therapy. Both groups improve insulin sensitivity and possibly pancreatic insulin secretion.Calcium antagonists and centrally acting antihypertensives seem to have neutral effects on glucose and lipid metabolism.In times of rising incidences of impaired glucose metabolisms, an adequate selection of antihypertensive drugs becomes more and more important since distinct properties of antihypertensive therapies are able to provide additional benefits.