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Diuretics effective for people with diabetes and high blood pressure

In people with diabetes, diuretics work as well as ACE-inhibitors and calcium channel blockers in protecting against heart attack and improving survival, and offer more protection against congestive heart failure.

The latest findings from the "Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial" or ALLHAT, sponsored by the National Heart, Lung, and Blood Institute, are published in the June 27 issue of Archives of Internal Medicine.

ALLHAT is the largest study to compare these three major classes of medications to treat high blood pressure. The study originally reported in 2002 that diuretics were more beneficial as initial treatment for high blood pressure for protecting against adverse cardiovascular outcomes. This latest analysis shows that even among diabetics and those with mildly elevated fasting glucose--a sign of pre-diabetes--the less costly diuretics are at least as effective, may be more beneficial for some people.

About 73 percent of adults with diabetes have high blood pressure--which in diabetic patients is defined as greater than or equal to 130/80 mm Hg-- or use prescription medications for their hypertension. Both diabetes and high blood pressure are major risk factors for coronary heart disease, and when both are present, significantly increase the risk for developing heart and kidney diseases. High blood pressure can lead to congestive heart failure, a condition in which the heart is weakened and cannot pump enough blood throughout the body.

"Controlling high blood pressure is an urgent concern especially for people with diabetes. Our findings demonstrate the advantages of diuretics in diabetics as well as in those with impaired and normal fasting glucose levels," said NHLBI director Dr. Elizabeth G. Nabel. "As a physician, I have seen the consequences of poorly controlled hypertension and diabetes. These results show many people and their families can be spared that devastation."

The
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Contact: NHLBI Communications Office
nhlbi_news@nhlbi.nih.gov
301 496-4236
NIH/National Heart, Lung, and Blood Institute
27-Jun-2005


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