Blood Pressure Drugs: A Gamble?

By Lucy Williams, Ivanhoe Health Correspondent

ORLANDO, Fla. (Ivanhoe Newswire) -- Blood pressure treatments and football bets have more in common than you might think. Recent research could help patients with high blood pressure boost their odds for better health and avoid diabetes.

Previous research suggests some blood pressure medications put patients at increased risk for new onset diabetes. Many of these drugs have never been directly compared, so how do doctors determine which medications are safest?

Researchers at Rush University Medical Center in Chicago took a hint from oddsmakers when comparing drugs in a recent study. They conducted a network meta-analysis of 22 clinical trials with 143,153 participants to determine which blood pressure medications put patients at risk for diabetes. Their meta-analysis shows angiotensin-receptor blockers (ARBS) and angiotensin-converting-enzyme inhibitors (ACE), two common blood pressure medications, are least likely to cause new cases of diabetes. This type of study enables researchers to compare diabetes risk across all classes of blood pressure drugs, similar to the way oddsmakers predict sports results.

"If you were interested in betting some money on the Bears and Saints NFL championship game, you would recognize those teams did not play this year. Reggie Bush has never seen the Chicago defense," William Elliott, M.D., Ph.D., of Rush University Medical Center in Chicago, told Ivanhoe. "Therefore, you would be at a difficult place to try to figure out which side to bet on."

Likewise, it can be difficult for doctors to prescribe the safest drugs without knowing how they compare head-to-head.

"The oddsmakers in Las Vegas and every place that makes book know that one technique for [comparison] is to look at the combined records of the Bears against a set of teams that also played the Saints this year," he said. "It's primarily that sort of indirect comparison that allows odds makers to determine who is more likely to win."

It's also the kind of indirect comparison that helps researchers identify which blood pressure drugs are safest for patients.

Improve Your Odds Today

Dr. Elliott said not to worry just yet about blood pressure drugs promoting diabetes. People who should be most concerned are those already at risk. Be cautious if you:

• Have a family history of diabetes
• Are overweight
• Have experienced recent weight gain
• Have a high fasting blood sugar

To avoid diabetes, consider making lifestyle changes. Some risk factors can't be changed, but you can modify your diet and exercise habits to improve your health and prevent diabetes.

"These things are probably more important for most people than deciding what medicine they should or shouldn't be taking for blood pressure," said Dr. Elliott. "Most hypertensive people in the United States are overweight, which is a risk factor for diabetes. You can't change your family members very easily, but you certainly can change your weight."

This article was reported by Ivanhoe.com, which offers Medical Alerts by e-mail every day of the week. To subscribe, click on: http://ivanhoe.com/newsalert/.

SOURCE: Ivanhoe interview with William Elliott, M.D., Ph.D., Rush University Medical Center in Chicago; Journal of Clinical Oncology, 2007;396:201-207