Antihypertensive medications: benefits of blood pressure lowering and hazards of metabolic effects

Expert Rev Cardiovasc Ther. 2009 Jun;7(6):689-702. doi: 10.1586/erc.09.31.


Blood pressure reduction is associated with significant reduction in adverse cardiovascular outcomes. Certain blood pressure-lowering drugs have adverse effects on glucose homeostasis, and have been associated with the development of both prediabetes and diabetes during use. There is controversy over the significance of diabetes that develops during treatment with antihypertensives and whether the benefits of blood pressure reduction offset the hazards of dysglycemia that can lead to diabetes. Many treatment guidelines have recently undergone revisions to include consideration for the metabolic effects of antihypertensive drugs, particularly in high-risk populations. This review summarizes the data related to the benefits of blood pressure reduction as well as the adverse metabolic effects and new-onset diabetes associated with some medications.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Antihypertensive Agents / adverse effects
  • Antihypertensive Agents / pharmacology*
  • Blood Pressure / drug effects*
  • Cardiovascular Diseases / prevention & control
  • Diabetes Mellitus / etiology
  • Glucose / metabolism
  • Homeostasis / drug effects
  • Humans
  • Hypertension / drug therapy*
  • Hypertension / physiopathology
  • Practice Guidelines as Topic
  • Risk Factors


  • Antihypertensive Agents
  • Glucose