Beta blocker and/or diuretic and diabetes risk

[sumihari]

Hi,

I have come across some studies that implicate the use of beta blockers especially when combined with a diuretic (thiazide type) as a cause of Diabetes.  As a result of the study concerned, I believe in the UK doctors have been urged to switch patients from this combination to something else for the treatment of blood pressure.

I have a strong family history of Type 2 diabetes and am 46 years old female. Recently due to some episodic spikes in my blood pressure I have been put on atenolol and my doctor would like me to add Micardis (thiazide diuretic and ARB) to this blocker. Now this is I guess common practice but this is exactly what the Professor in charge of the study has asked doctors not to do.

Would you know anything about this? Thanks.

Sumi

[Anita Ramsetty, MD]

Hello,
There is some data to suggest that beta-blockers can "tip" someone prone to diabetes into that range of high blood sugars. The same goes for several other medications in fact, including Niacin which is commonly used for high cholesterol. The combination of medications you described is quite commonly used as some of the first agents for treatment of high blood pressure, even in a population of those with diabetes or prone to diabetes. Control of your blood pressure is of course extremely important. Please discuss your concerns with your doctor. Perhaps he/she would consider switching you to a different combination given your concerns, or alternatively simply watch and test you for hyperglycemia in future.

Take care

[Anita Ramsetty, MD]

Dear Sumi,

You are right: if the muscle spasms tend to drive your blood pressure, those need t be addressed as well. Then if treating them takes care of the blood pressure, you will not need the anti-hypertensives as much.In the meantime though it is important t keep your pressure controlled so it does not have time to do any damage to your body.
I am not sure of a good website for the review of the study you mentioned, but I will keep looking.

Take care.

[sumihari]

Thank you for your reply

Sumi

[sumihari]

Hi Anita,

Thank you for your reply and I find it interesting to note that the combination I have mentioned is a common first line agents for treatment of high blood pressure with or without diabetes. It is at times difficult to discuss with ones doctor about concerns as many are actually not aware of the connection and or of the study. Is there a good website  with this study results ( a website a doctor would trust). I came across this study in a British article.  My blood pressure appears to be anxiety driven but I have a lot of neck and thoracic muscle spasms which contributes to the increase in general anxiety , hence higher blood pressure. To date the muscular spasms haven't been fixed, so my thoughts are why bother treating the symptoms , might work for a while only to get worse and I then probably need more and more medications.

I will take your advice and discuss with my doctor .

Thank you again.

Sumi