Reducing the Risk of Developing Diabetes: The Role of Angiotensin Receptor Blockers and Angiotensin Converting Enzyme Inhibitors in Patients With Hypertension Combined Prediabetes

Abstract

Diabetes has emerged as a pressing public health crisis in numerous nations, with individuals afflicted by hypertension exhibiting an elevated susceptibility to diabetes. Our main objective was to investigate the risk of developing new-onset diabetes in hypertensive patients with pre-diabetes undergoing treatment with angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs), thereby furnishing valuable evidence for informed clinical decision-making. Our study was a retrospective cohort study in which individuals with hypertension and meeting other inclusion criteria were enrolled into the cohort. The study population was divided into two groups: one group receiving ARBs or ACEIs as antihypertensive medications, and the other group receiving calcium antagonists, diuretics, beta-blockers, or alpha-blockers. Kaplan–Meier curve and Cox proportional hazard model were used to evaluate the cumulative incidence and hazard ratio (HR) of new-onset diabetes in the ARBs or ACEIs grouprespectively. Out of the 1373 hypertensive individualswith pre-diabetes included in the study, 385 were prescribed ARBs or ACEIs for hypertension management. Subsequent follow-up revealed that 24 new cases of diabetes emerged in the ARBs or ACEIs group, whereas 104 cases were reported in the comparison group. Utilization of ARBs or ACEIs as antihypertensive therapy was linked to a decreased risk of incident diabetes compared to the alternative regimen (HR: 0.51, 95% CI: 0.33, 0.79) and was statistically significant in the male population. In conclusion, antihypertensive drugs of the ACEIs and ARBs class reduce the risk of new-onset diabetes in patients with hypertension combinedwith pre-diabetes.