Do blood pressure drugs contribute to death from kidney disease or diabetes?

This study compared the mortality rate associated with different antihypertensive drugs, in particular mortality related to diabetes and renal disease. 

Hypertension is a common medical condition where pressure in the blood vessels is high. Uncontrolled high blood pressure can damage or weaken blood vessels in the kidney and other organs leading to renal (kidney) disease, and causing or worsening diabetic complications.

Several classes of medications are currently available for treating hypertension and are collectively termed antihypertensive drugs. These include angiotensin-converting enzyme inhibitors (ACEI), alpha-blockers, beta-blockers and calcium channel blockers (CCBs) which all work to relax blood vessels and therefore prevent blood vessel damage. Additionally, thiazide diuretics are commonly used which act on the kidneys to help eliminate sodium and water from the body, reducing the volume of the blood. Currently, it remains unclear whether these drugs all have similar effects on mortality, and in particular mortality related to diabetes and kidney disease. 

This study collected data from 218,047 patients receiving their first-ever antihypertensive drug. Patients were grouped according to their initial drug prescription and a follow-up study occurred five years after. Overall mortality (death) and mortality due to diabetes or kidney disease was compared across the different drug groups.

The main findings of this study found that within five years after their first-ever antihypertensive prescription, 15.3% of the participants passed away. Overall, 0.48% of the participants’ deaths were related to kidney disease and diabetes. Furthermore, each class of drug showed to have similar association with mortality from kidney disease and diabetes. 

The authors concluded that all of the major antihypertensive drugs used in this study are suitable as a first-line drug for hypertension management.

While mortality was used as an outcome in this study, other factors such as quality of life or adverse effects would have provided a more comprehensive measure of the effectiveness of these different antihypertensive drugs. Furthermore, combination therapy was excluded which often has benefits over single drug therapy.  

While it is important to note that the major drug classes mentioned in this study provide similar survival rates, you should also take into account and discuss with your doctor the possibility of combination therapy or any adverse effects or drug interactions that may occur within these drug groups.