[Choice of first line treatment for arterial hypertension: should one avoid dihydropyridines in diabetic patients?].

Abstract

Choice of first-line treatment for arterial hypertension: should dihydropiridines be avoided in diabetic patients? The use of dihydropyridines as first-line antihypertensive drugs in Type 2 (non-insulin-dependent) diabetic subjects has recently been challenged by several clinical trials that found increased risk of cardiovascular events (sudden death and myocardial infarction). This report provides a critical appraisal of available data. The main shortcomings of these trials are that clinical events were secondary outcomes in studies designed for other purposes (effects of antihypertensive drugs on blood pressure control or metabolic tolerance); that control groups on placebo or reference treatment were lacking in both trials; and that one trial was stopped at the request of the safety committee. Therefore, estimates of potentially adverse effects are imprecise and may be biased. Until data from large-scale ongoing trials are available, dihydropyridines should continue to be used as second-step antihypertensive drugs in Type 2 patients.

• Authors: G Chatellier, M Marre
• Journal: Diabetes & metabolism (Diabetes Metab) Vol. 24 Issue 4 Pg. 370-5 (Sep 1998) ISSN: 1262-3636 [Print] France
• Vernacular Title: Choix du traitement de premiere intention de l'hypertension artérielle: doit-on éviter les dihydropyridines chez les diabétiques?
• PMID: 9805651 (Publication Type: Journal Article, Review)

Chemical References

• Antihypertensive Agents
• Dihydropyridines

Topics

• Antihypertensive Agents
• Blood Pressure
• Cardiovascular Diseases (chemically induced, epidemiology)
• Contraindications
• Diabetic Angiopathies (drug therapy)
• Dihydropyridines
• Humans
• Hypertension (drug therapy)
• Risk Factors