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'Diuretics increase risk of diabetes'

A new analysis of data from the landmark ALLHAT trial adds to concerns over antihypertensive therapy, after finding that patients taking a diuretic have a significantly in- creased risk of developing diabetes.

The analysis, presented at the American Society of Hypertension's annual meeting in New York last week, looked at the incidence of diabetes and impaired fasting glucose in hypertensive patients random-ised to an ACE-inhibitor, a diuretic or a calcium channel blocker over 4.9 years of follow-up.

Researchers found the incidence of diabetes – measured by fasting glucose level of more than 125mg/dl – was 11.5 per cent in patients taking a diuretic, compared with 7.6 per cent in those taking an ACE-inhibitor. However, diuretic doses were higher than those commonly used in the UK.

Preliminary guidance from NICE recommends against a combination of a diuretic and a ß-blocker because of existing trial data suggesting an increased risk of diabetes for the combination.

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