Second Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, Hippokration Hospital, Thessaloniki, Greece.
Curr Vasc Pharmacol. 2010 Nov;8(6):792-803. doi: 10.2174/157016110793563906.
Antihypertensive agents exert different effects on insulin sensitivity, lipids and haemostasis. However, most studies assessing these effects were small and short-term yielding conflicting results. Moreover, it has not been established whether the impact of antihypertensive drugs on insulin sensitivity, lipids, thrombosis and fibrinolysis adds to or attenuates vascular risk reduction. On the other hand, new onset type 2 diabetes mellitus (T2DM) appears to be more frequent in patients treated with β-blockers and diuretics, whereas angiotensin converting enzyme inhibitors and angiotensin receptor blockers might reduce the risk for T2DM and calcium channel blockers have a neutral effect. Therefore, the risk of developing T2DM should be considered when selecting an antihypertensive agent. This review discusses the differential effects of antihypertensive drugs on insulin sensitivity, lipids and haemostasis and considers their association with vascular risk.
抗高血压药物对胰岛素敏感性、血脂和止血有不同的影响。然而，大多数评估这些影响的研究规模较小且时间较短，结果相互矛盾。此外，抗高血压药物对胰岛素敏感性、血脂、血栓形成和纤溶的影响是否会增加或降低血管风险还没有确定。另一方面，β受体阻滞剂和利尿剂治疗的患者似乎更容易发生新发 2 型糖尿病（T2DM），而血管紧张素转换酶抑制剂和血管紧张素受体阻滞剂可能降低 T2DM 的风险，钙通道阻滞剂则无影响。因此，在选择抗高血压药物时应考虑发生 T2DM 的风险。本文讨论了抗高血压药物对胰岛素敏感性、血脂和止血的不同影响，并考虑了它们与血管风险的关系。
