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VIEWPOINT

Cardiovascular therapies and risk for development of diabetes

^* Division of Cardiovascular Medicine, University of Florida, Gainesville, Florida, USA

Manuscript received February 6, 2004; revised manuscript received March 19, 2004, accepted March 23, 2004.

^* Reprint requests and correspondence: Dr. Carl J. Pepine, Division of Cardiovascular Medicine, University of Florida, 1600 S.W. Archer Road, Gainesville, Florida 32610-0277, USA.
pepincj{at}medicine.ufl.edu

The prevalence of diabetes is increasing, and patients with diabetes are at increased risk of adverse cardiovascular outcomes. Recently, the results from 11 large randomized clinical trials have suggested a difference in the emergence of new diabetes according to cardiovascular medication use. Treatment with angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, and calcium antagonists yielded a lower incidence of diabetes development than beta-blockers and diuretics. Physicians should consider this possible diabetes consequence when prescribing long-term beta-blockers and diuretics, particularly in patients at high risk of developing diabetes.

Abbreviations and Acronyms   ACE = angiotensin-converting enzyme   ARB = angiotensin receptor blocker   BB = beta-blocker   CA = calcium antagonist   CAD = coronary artery disease   CV = cardiovascular   HCTZ = hydrochlorothiazide   HOPE = Heart Outcomes Prevention Evaluation   SCOPE = Study on Cognition and Prognosis in the Elderly   STOP-2 = Swedish Trial in Old Patients with Hypertension-2

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