This paper consists of subgroup analyses from ALLHAT, trying to work out how it is that some blood pressure lowering agents—notably the thiazide diuretics—increase blood sugar but still appear to protect against cardiovascular events. The conclusion is worth pondering on: “Fasting glucose levels increase in older adults with hypertension regardless of treatment type. For those taking chlortalidone vs other medications, the risk of developing fasting glucose levels above 6.9 mmol/L is modestly greater, but there is no conclusive or consistent evidence that this diuretic-associated increase in diabetes risk increases the risk of clinical events.
Arch Intern Med 13 Nov 2006
