New-onset type 2 diabetes diagnoses: 9883 participants
Reducing systolic blood pressure by 5 mm Hg reduced the risk of type 2 diabetes across all trials by 11%
Hazard ratio 0.89 (95% CI, 0.84 to 0.95)
Compared to placebo, the following antihypertensive drugs reduced the risk of new-onset type 2 diabetes
Angiotensin-converting enzyme inhibitors
Relative risk (RR) 0.84 (95% CI, 0.76 to 0.93)
Angiotensin II receptor blockers
RR 0.84 (95% CI, 0.76 to 0.92)
There was an increased risk of new-onset type 2 diabetes with
RR 1.48 (95% CI, 1.27 to 1.72)
RR 1.20 (95% CI, 1.07 to 1.35)
No effect was found for calcium channel blockers
RR 1.02 (95% CI, 0.92 to 1.13)
There was an 11% reduction in the risk of new-onset type 2 diabetes per 5 mm Hg lower systolic blood pressure
Angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers having the most favorable outcomes, while β blockers and thiazide diuretics had a negative effect
The authors state
…this study has shown consistent evidence to suggest that the preventive effect of blood pressure reduction on type 2 diabetes risk is causal, and therefore reducing blood pressure is likely to prevent new-onset type 2 diabetes
This evidence also supports the indication for selected classes of antihypertensive drugs for the prevention of type 2 diabetes, which could further refine the selection of drug choice according to an individual’s risk profile
In particular, ACEIs and ARBs should be considered as having the most favourable outcomes
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