A Study of Long-term Effect of Antihypertensive drugs on the Risk of New-onset Diabetes

• Main Authors: Shu-Yi Li, 李淑怡
• Other Authors: 馬作鏹
• Format: Others
• Language: en_US
• Published: 2008
• Online Access: http://ndltd.ncl.edu.tw/handle/43470778078116610053

碩士 === 中國醫藥大學 === 醫務管理學研究所碩士班 === 96 === Aims：Antihypertensive drugs have been linked to new-onset diabetes (NOD); however, data on the effect of these drugs on the development of NOD in hypertensive patients has not been well determined. This study aimed to investigate the association between antihypertensive drugs and NOD. Methods：This was a retrospective cohort study performed using data from claim forms provided to the central region branch of the Bureau of National Health Insurance in Taiwan from January 2002 to December 2006. Prescriptions for antihypertensive drugs before the index date were retrieved from a prescription database. We estimated the odds ratios (ORs) of NOD associated with antihypertensive drug use; nondiabetic subjects served as the reference group. Results：A total of 4183 NOD cases were identified in 23280 hypertensive patients during the study period. The risk of NOD was higher among monotherapy users of diuretics (OR, 1.10; 95% confidence interval (CI), 1.01-1.20), beta-blockers (OR, 1.12; 95% CI, 1.04-1.21), and calcium channel blockers (OR, 1.10; 95% CI, 1.02-1.18) than among non-users. Patients who took angiotensin- converting enzyme (ACE) inhibitors (OR, 0.92; 95% CI, 0.84-1.00), or alpha-blockers (OR, 0.88; 95% CI, 0.80-0.98) were at a lower risk of developing NOD than non-users. Angiotensin receptor blockers, and vasodilators were not associated with risk of NOD. The risk of NOD was higher among double combinations of diuretics plus beta-blockers (OR, 1.14; 95% confidence interval (CI), 1.06-1.22), diuretics plus calcium channel blockers (OR, 1.09; 95% CI, 1.01-1.17), and beta-blockers plus calcium channel blockers (OR, 1.11; 95% CI, 1.03-1.19) than among non-users. Patients who took angiotensin- converting enzyme (ACE) inhibitors, or alpha-blockers were at a lower risk of among double or three drug combinations developing NOD than non-users. Angiotensin receptor blockers, and vasodilators were not associated with risk of NOD among double or three drug combinations. Conclusions：The results of this study suggest that hypertensive patients who take ACE inhibitors or alpha-blockers are at lower risk of NOD. Diuretics, beta-blockers, and calcium-blockers are associated with a significant increase in the risk of NOD.