To determine whether changes in serum glucose, serum potassium, and plasma insulin levels are correlated in a cohort of hypertensive patients. Prespecified subgroup analysis of results from a prospective, multicenter, randomized, open-label, parallel-group study. Community-based ambulatory population of patients age range 17—65 yrs with a new diagnosis of hypertension, untreated hypertension, or known hypertension, who were previously treated with fewer than three antihypertensive drugs and had no evidence of cardiovascular disease or diabetes mellitus. Monotherapy with oral hydrochlorothiazide Fasting serum glucose, serum potassium, and plasma insulin levels were obtained at baseline before hydrochlorothiazide therapy was started and after 9 weeks of therapy. Changes in serum glucose levels did not differ significantly between patients maintaining serum potassium levels of 4.
Joel M. Hypertension May Elliott WJ. Hypertension May. Two crossover studies confirm adverse effects of thiazide diuretics — but not of potassium-sparing diuretics or beta-blockers — on short-term glucose tolerance. Previous studies have shown a small but significant increase in incidence of type 2 diabetes in patients with hypertension treated with thiazide diuretics. In an industry-supported study, investigators conducted two double-blind, placebo-controlled, crossover trials comparing the effects of a thiazide diuretic versus a beta-blocker and of a potassium-sparing diuretic versus hydrochlorothiazide on oral glucose tolerance in patients with essential hypertension. In the first trial, 41 patients had a significant increase in blood glucose during a 2-hour oral glucose tolerance test OGTT after 4 weeks of bendroflumethiazide treatment, but not after 4 weeks of atenolol treatment.
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