Can certain tablets for high blood pressure prevent type-2 diabetes?

This study looked at whether high blood pressure drugs, angiotensin converting enzyme inhibitors, reduce the risk of new-onset type-2 diabetes.

Diabetes, or diabetes mellitus, is a disease that results in uncontrolled high blood sugar. High blood sugar occurs mainly due to the body not producing insulin (type-1 diabetes), a hormone needed to reduce blood sugar, or the body no longer responding to insulin (type-2 diabetes). All types of diabetes result in too much sugar in the blood, which can lead to serious health problems such as kidney failure, nerve death and blindness. Diabetes is frequently diagnosed after irreversible damage to the body’s cells and organs has already occurred, thus, prevention is better than treatment.

Angiotensin converting enzyme inhibitors (ACEIs) are used to treat high blood pressure and coronary artery disease by helping to relax blood vessels and in turn reduce the risks of heart attack and stroke. However, recent evidence has suggested that ACEIs reduce the risk of developing type-2 diabetes and may help prevent of type-2 diabetes. Examples of ACEIs are Lotensin, Capoten, Vasotex and Prinivil.

This study evaluated the use of ACEIs conducted in previous studies to see whether they help prevent the onset of type-2 diabetes. This study included a total of 92,404 patients, of which 72,128 were non-diabetic at the start of each study investigated. In all studies, it was found that the likelihood of developing type-2 diabetes was significantly reduced by 20% among patients receiving ACEIs compared to those who did not receive any high blood pressure medication and by 15% compared to those who received calcium channel blockers (another type of high blood pressure medication).

ACEIs also reduced the onset of type-2 diabetes among patients with high blood pressure, cardiovascular disease or heart failure. 

The authors concluded that ACEIs are effective in preventing the onset of type-2 diabetes even in patients with high blood pressure, cardiovascular disease and heart failure. Because of this additional benefit, ACEIs could be the medication of choice for some patients being treated for high blood pressure. 

Most participants recruited in these trials were white, thus this may limit the application of these findings to other races.