This Article Figures Only Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Cooper-DeHoff, R. M. Articles by Pepine, C. J. Search for Related Content PubMed PubMed Citation Articles by Cooper-DeHoff, R. M. Articles by Pepine, C. J.

STATE-OF-THE-ART PAPER

Cardiovascular Therapies and Associated Glucose Homeostasis

Implications Across the Dysglycemia Continuum

Rhonda M. Cooper-DeHoff, PharmD, MS^_*,_*, Michael A. Pacanowski, PharmD, MPH and Carl J. Pepine, MD, MACC^_*

^_* Division of Cardiovascular Medicine, College of Medicine, University of Florida, Gainesville, Florida
Department of Pharmacy Practice and Center for Pharmacogenomics, College of Pharmacy, University of Florida, Gainesville, Florida

Manuscript received April 7, 2008; revised manuscript received October 27, 2008, accepted October 28, 2008.

^_* Reprint requests and correspondence: Dr. Rhonda M. Cooper-DeHoff, Division of Cardiovascular Medicine, University of Florida College of Medicine, P.O. Box 100277, Gainesville, Florida 32610-0277 (Email: dehofrm{at}medicine.ufl.edu).

Certain cardiovascular drugs have adverse effects on glucose homeostasis, which may lead to important long-term implications for increased risks of adverse outcomes. Thiazide diuretics, niacin, and beta-adrenergic blockers impair glucose homeostasis. However, angiotensin-converting enzyme inhibitors and angiotensin receptor blockers have demonstrated beneficial metabolic effects. The newer vasodilating beta-blocking agents and calcium antagonists appear to be metabolically neutral. These considerations, in addition to meticulous attention to blood pressure control and lifestyle changes, have the potential to beneficially modify glycemia and long-term risks. These considerations have particular importance in younger patients who may also have pre-diabetes or the metabolic syndrome and who are likely to require therapy over the course of decades.

Key Words: metabolic syndrome • pre-diabetes • thiazide diuretic • dysglycemia • glucose homeostasis

Abbreviations and Acronyms   ACE = angiotensin-converting enzyme   ARB = angiotensin receptor blocker   BP = blood pressure   CAD = coronary artery disease   CHD = coronary heart disease   CV = cardiovascular   HDL-C = high-density lipoprotein cholesterol   IFG = impaired fasting glucose   IGT = impaired glucose tolerance   MetSyn = metabolic syndrome   RAAS = renin-angiotensin-aldosterone system

This article has been cited by other articles:

				P. Ruggenenti, G. Lauria, I. P. Iliev, A. Fassi, A. P. Ilieva, S. Rota, C. Chiurchiu, D. P. Barlovic, A. Sghirlanzoni, R. Lombardi, et al. Effects of Manidipine and Delapril in Hypertensive Patients With Type 2 Diabetes Mellitus: The Delapril and Manidipine for Nephroprotection in Diabetes (DEMAND) Randomized Clinical Trial Hypertension, November 1, 2011; 58(5): 776 - 783. [Abstract] [Full Text] [PDF]

				B. V. Khan The effect of amlodipine besylate, losartan potassium, olmesartan medoxomil, and other antihypertensives on central aortic blood pressure and biomarkers of vascular function Therapeutic Advances in Cardiovascular Disease, October 1, 2011; 5(5): 241 - 273. [Abstract] [PDF]

				W. S. Aronow, J. L. Fleg, C. J. Pepine, N. T. Artinian, G. Bakris, A. S. Brown, K. C. Ferdinand, M. A. Forciea, W. H. Frishman, C. Jaigobin, et al. ACCF/AHA 2011 Expert Consensus Document on Hypertension in the Elderly: A Report of the American College of Cardiology Foundation Task Force on Clinical Expert Consensus Documents Circulation, May 31, 2011; 123(21): 2434 - 2506. [Full Text] [PDF]

				W. S. Aronow, J. L. Fleg, C. J. Pepine, N. T. Artinian, G. Bakris, A. S. Brown, K. C. Ferdinand, M. Ann Forciea, W. H. Frishman, C. Jaigobin, et al. ACCF/AHA 2011 Expert Consensus Document on Hypertension in the Elderly: A Report of the American College of Cardiology Foundation Task Force on Clinical Expert Consensus Documents Developed in Collaboration With the American Academy of Neurology, American Geriatrics Society, American Society for Preventive Cardiology, American Society of Hypertension, American Society of Nephrology, Association of Black Cardiologists, and European Society of Hypertension J. Am. Coll. Cardiol., May 17, 2011; 57(20): 2037 - 2114. [Full Text] [PDF]

				F. Mahfoud, M. Schlaich, I. Kindermann, C. Ukena, B. Cremers, M. C. Brandt, U. C. Hoppe, O. Vonend, L. C. Rump, P. A. Sobotka, et al. Effect of Renal Sympathetic Denervation on Glucose Metabolism in Patients With Resistant Hypertension: A Pilot Study Circulation, May 10, 2011; 123(18): 1940 - 1946. [Abstract] [Full Text] [PDF]

				M. E. R. Gomes, A. Mulder, L. Bellersen, F. W. A. Verheugt, P. Smits, and C. J. Tack Alpha-receptor blockade improves muscle perfusion and glucose uptake in heart failure Eur J Heart Fail, October 1, 2010; 12(10): 1061 - 1066. [Abstract] [Full Text] [PDF]

				J. J. Tessier, S. K. Neu, and K. K. Horning Thyrotoxic Periodic Paralysis (TPP) in a 28-Year-Old Sudanese Man Started on Prednisone J Am Board Fam Med, July 1, 2010; 23(4): 551 - 554. [Abstract] [Full Text] [PDF]

				C. J. Pepine Insulin as a Cardiovascular Therapeutic: Improving Glycemic Control in Patients With Coronary Artery Disease J. Am. Coll. Cardiol., February 3, 2009; 53(5_Suppl_S): S1 - S2. [Full Text] [PDF]